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General NPI Number Information
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NPI Number | 1740503630
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Entity Type | Organization
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Legal Business Name | COMPLETE CARE HOME HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 03/05/2010
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Last Update Date | 03/05/2010
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Provider Practice Location Address
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Address Line | 6442 COLDWATER CANYON AVE SUITE 102
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91606-1137
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Country | US
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Telephone | 818-980-1641
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Fax | 818-980-1651
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Provider Business Mailing Address
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Address Line | 6442 COLDWATER CANYON AVE SUITE 102
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91606-1137
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Country | US
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Telephone | 818-980-1641
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Fax | 818-980-1651
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. MAURICIO RAYCO
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Credential | PH.D.
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Telephone | 818-980-1641
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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 |
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License Number State |
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