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General NPI Number Information
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NPI Number | 1508688730
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Entity Type | Organization
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Legal Business Name | CP LA COUNTY SOUTH S-CA HH, LLC
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Dates
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Enumeration Date | 10/29/2024
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 5315 TORRANCE BLVD STE B-169
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City | TORRANCE
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State | CA
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Zip | 90503-4011
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Country | US
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Telephone | 310-543-3450
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Fax |
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Provider Business Mailing Address
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Address Line | 5315 TORRANCE BLVD STE B-169
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City | TORRANCE
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State | CA
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Zip | 90503-4011
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | TERRI WARREN
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Credential |
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Telephone | 310-480-2982
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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 |
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License Number State |
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