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General NPI Number Information
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NPI Number | 1447637368
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Entity Type | Organization
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Legal Business Name | MOSHEAHOMECARE
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Dates
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Enumeration Date | 04/29/2015
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Last Update Date | 04/29/2015
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Provider Practice Location Address
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Address Line | 12219 HAWTHORNE BLVD SUITE # 202
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City | HAWTHORNE
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State | CA
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Zip | 90250-3807
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Country | US
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Telephone | 323-688-9755
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Fax |
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Provider Business Mailing Address
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Address Line | 12219 HAWTHORNE BLVD SUITE # 202
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City | HAWTHORNE
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State | CA
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Zip | 90250
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Country | US
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Telephone | 323-688-9755
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Fax |
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Authorized Official
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Title or Position | GM
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Name | MISS MICHELLE CACHO
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Credential |
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Telephone | 323-688-9755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 03241130
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License Number State | CA
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