=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568701795
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HELPING HANDS ASST HOME CARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/07/2013
-----------------------------------------------------
Last Update Date | 02/07/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3594 CORDOVA CT
-----------------------------------------------------
City | NEWBURY PARK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91320-2037
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-341-1030
-----------------------------------------------------
Fax | 805-262-2732
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3594 CORDOVA CT
-----------------------------------------------------
City | NEWBURY PARK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91320-2037
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-341-1030
-----------------------------------------------------
Fax | 805-262-2732
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PRESIDENT
-----------------------------------------------------
Name | DR. DOROTHY GAINE
-----------------------------------------------------
Credential | PH.D.
-----------------------------------------------------
Telephone | 805-341-1030
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | MFC20466
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number | MFC20466
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 261QM0801X
-----------------------------------------------------
Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
License Number | MFC20466
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------