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General NPI Number Information
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NPI Number | 1932912334
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Entity Type | Organization
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Legal Business Name | STACEY'S HOME HEALTH INCORPORATED
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Dates
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Enumeration Date | 01/29/2025
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 30700 RUSSELL RANCH RD STE 250
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91362-9507
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Country | US
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Telephone | 805-638-2918
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Fax |
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Provider Business Mailing Address
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Address Line | 30700 RUSSELL RANCH RD STE 250
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91362-9507
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Country | US
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Telephone | 805-638-2918
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Fax | 805-855-4148
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Authorized Official
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Title or Position | CEO
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Name | STACEY SCHULTHEIS
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Credential | RN
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Telephone | 805-638-2918
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #6
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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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