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General NPI Number Information
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NPI Number | 1659365948
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Entity Type | Organization
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Legal Business Name | EXCELLENT IN-HOME CARE INC
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Dates
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Enumeration Date | 09/01/2005
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Last Update Date | 05/12/2008
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Provider Practice Location Address
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Address Line | 16601 VENTURA BLVD #506
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City | ENCINO
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State | CA
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Zip | 91436-1921
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Country | US
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Telephone | 818-755-4900
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Fax | 818-654-0336
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Provider Business Mailing Address
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Address Line | 16601 VENTURA BLVD #506
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City | ENCINO
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State | CA
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Zip | 91436-1921
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Country | US
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Telephone | 818-755-4900
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Fax | 818-654-0336
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Authorized Official
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Title or Position | ADMINISTRATOR/OWNER
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Name | DR. KHOSROW ASSADI
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Credential |
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Telephone | 818-755-4900
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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 | 980001145
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License Number State | CA
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