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General NPI Number Information
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NPI Number | 1952096687
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Entity Type | Organization
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Legal Business Name | URR EPIPHANY
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Dates
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Enumeration Date | 04/10/2023
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Last Update Date | 04/10/2023
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Provider Practice Location Address
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Address Line | 147 W 99TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90003-4114
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Country | US
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Telephone | 805-279-1907
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Fax |
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Provider Business Mailing Address
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Address Line | 2127 W 78TH PL
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City | LOS ANGELES
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State | CA
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Zip | 90047-2605
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Country | US
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Telephone | 805-279-1907
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Fax |
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Authorized Official
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Title or Position | OWNER/FOUNDER
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Name | MS. SUNSET OLINEY
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Credential |
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Telephone | 805-279-1907
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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