=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780966796
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GREEN VALLEY HOME HEALTH CARE & HOSPICE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/15/2011
-----------------------------------------------------
Last Update Date | 09/22/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3009 DOUGLAS BLVD 160
-----------------------------------------------------
City | ROSEVILLE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95661-3859
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-757-6800
-----------------------------------------------------
Fax | 916-787-1001
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3009 DOUGLAS BLVD 160
-----------------------------------------------------
City | ROSEVILLE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95661-3859
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-757-6800
-----------------------------------------------------
Fax | 916-787-1001
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MRS. NAJMEEN SHERAZEE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 916-801-7002
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------