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General NPI Number Information
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NPI Number | 1750943304
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Entity Type | Organization
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Legal Business Name | WELLSTAR HOME HEALTH SERVICES, INC
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Dates
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Enumeration Date | 07/03/2019
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Last Update Date | 03/23/2022
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Provider Practice Location Address
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Address Line | 479 MASON ST STE 309
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City | VACAVILLE
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State | CA
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Zip | 95688-4542
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Country | US
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Telephone | 707-689-5674
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Fax | 707-689-5274
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Provider Business Mailing Address
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Address Line | 479 MASON ST STE 309
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City | VACAVILLE
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State | CA
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Zip | 95688-4542
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Country | US
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Telephone | 707-689-5674
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Fax | 707-689-5274
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Authorized Official
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Title or Position | OWNER
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Name | SYRIL SIMON
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Credential |
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Telephone | 718-316-5603
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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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