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General NPI Number Information
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NPI Number | 1720589997
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Entity Type | Organization
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Legal Business Name | YOUR HOME CARE
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Dates
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Enumeration Date | 02/23/2018
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Last Update Date | 02/23/2018
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Provider Practice Location Address
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Address Line | 24191 PASEO DA VALENCIA SUITE B
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City | LAGUNA WOODS
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State | CA
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Zip | 92637
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Country | US
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Telephone | 949-424-9322
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Fax |
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Provider Business Mailing Address
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Address Line | 24191 PASEO DA VALENCIA SUITE D
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City | LAGUNA WOODS
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State | CA
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Zip | 92637
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Country | US
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Telephone | 949-424-9322
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Fax |
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Authorized Official
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Title or Position | BUSINESS DEVELOPMENT
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Name | MRS. ALISHA FOREMAN
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Credential |
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Telephone | 949-424-9322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 306005324
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 304700158
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License Number State | CA
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