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General NPI Number Information
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NPI Number | 1801862578
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Entity Type | Organization
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Legal Business Name | GREEN VALLEY HOMEHEALTH SERVICES, INC
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Dates
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Enumeration Date | 02/23/2006
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Last Update Date | 01/23/2008
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Provider Practice Location Address
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Address Line | 19031 US HIGHWAY 18 SUITE 180
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City | APPLE VALLEY
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State | CA
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Zip | 92308-2515
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Country | US
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Telephone | 760-242-7009
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Fax |
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Provider Business Mailing Address
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Address Line | 19031 US HIGHWAY 18 STE 180
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City | APPLE VALLEY
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State | CA
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Zip | 92308-2515
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Country | US
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Telephone | 760-242-7009
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Fax | 760-242-7020
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. AMALIA RAYA
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Credential |
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Telephone | 760-242-7009
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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 | 00005331
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License Number State | CA
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