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General NPI Number Information
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NPI Number | 1861618167
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Entity Type | Organization
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Legal Business Name | VESTA HEALTHCARE CORPORATION
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 06/29/2010
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Provider Practice Location Address
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Address Line | 1445 HUNTINGTON DR SUITE 260
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City | SOUTH PASADEN
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State | CA
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Zip | 91030-5469
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Country | US
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Telephone | 626-799-5700
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Fax | 626-799-0329
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Provider Business Mailing Address
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Address Line | 1445 HUNTINGTON DR SUITE 260
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City | SOUTH PASADENA
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State | CA
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Zip | 91030-5469
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Country | US
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Telephone | 626-799-5700
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Fax | 626-799-0329
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Authorized Official
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Title or Position | PRESIDENT-CEO
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Name | MR. JOVIE YABES
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Credential | R.N.
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Telephone | 626-288-3300
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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 | 980001591
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License Number State | CA
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