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General NPI Number Information
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NPI Number | 1740722826
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Entity Type | Organization
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Legal Business Name | CITYCARE HOMEHEALTH PROVIDER INC
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Dates
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Enumeration Date | 11/07/2016
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Last Update Date | 11/07/2016
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Provider Practice Location Address
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Address Line | 11633 HAWTHORNE BLVD SUITE 401
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City | HAWTHORNE
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State | CA
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Zip | 90250-2321
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Country | US
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Telephone | 323-202-6920
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Fax | 310-695-1521
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Provider Business Mailing Address
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Address Line | 11633 HAWTHORNE BLVD SUITE 401
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City | HAWTHORNE
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State | CA
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Zip | 90250-2321
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Country | US
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Telephone | 323-202-6920
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Fax | 310-695-1521
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. KUNLE S ONIFADE
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Credential |
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Telephone | 323-202-6920
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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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