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General NPI Number Information
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NPI Number | 1700295656
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Entity Type | Organization
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Legal Business Name | CROWN OF SPLENDOR HOMECARE, LLC
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Dates
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Enumeration Date | 08/05/2014
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Last Update Date | 08/05/2014
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Provider Practice Location Address
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Address Line | 1974 SAN JUAN ST
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City | TUSTIN
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State | CA
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Zip | 92780-5207
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Country | US
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Telephone | 714-271-4793
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Fax |
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Provider Business Mailing Address
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Address Line | 1974 SAN JUAN ST
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City | TUSTIN
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State | CA
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Zip | 92780-5207
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Country | US
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Telephone | 714-271-4793
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | FRANZEEMA SMITH
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Credential |
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Telephone | 714-271-4793
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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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