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General NPI Number Information
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NPI Number | 1871917567
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Entity Type | Organization
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Legal Business Name | ANCESTRAL HOME HEALTH CARE PROVIDERS, INC.
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Dates
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Enumeration Date | 02/14/2014
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Last Update Date | 02/14/2014
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Provider Practice Location Address
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Address Line | 15335 MORRISON ST STE 218
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-1599
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Country | US
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Telephone | 818-789-5888
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Fax | 818-789-0561
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Provider Business Mailing Address
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Address Line | 15335 MORRISON ST STE 218
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-1599
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MA THERESITA MACARANAS BENITEZ
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Credential |
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Telephone | 818-789-5888
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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 | 980001129
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License Number State | CA
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