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General NPI Number Information
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NPI Number | 1669399754
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Entity Type | Organization
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Legal Business Name | OCTOPUS COMMUNITY CARE NETWORK, INC
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Dates
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Enumeration Date | 06/30/2026
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Last Update Date | 06/30/2026
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Provider Practice Location Address
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Address Line | 229 N CENTRAL AVE STE 610
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City | GLENDALE
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State | CA
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Zip | 91203-3533
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Country | US
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Telephone | 310-331-2902
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Fax | 888-414-7839
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Provider Business Mailing Address
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Address Line | 229 N CENTRAL AVE STE 610
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City | GLENDALE
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State | CA
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Zip | 91203-3533
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Country | US
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Telephone | 310-331-2902
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Fax | 888-414-7839
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Authorized Official
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Title or Position | CEO/ADMINISTRATOR
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Name | SHELLYDALE P GRAY
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Credential | ADMINISTRATION
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Telephone | 310-331-2902
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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