MEDICARE: DAY & NITE CARE @ HOME, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1013483429
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAY & NITE CARE @ HOME, INC.

Provider Business Mailing Address
First Line	:	356B W COLORADO ST
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91204-1603
Country	:	US
Telephone Number	:	818-548-2722
Fax Number	:	818-548-2723

Provider Business Practice Location Address
First Line	:	356B W COLORADO ST
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91204-1603
Country	:	US
Telephone Number	:	818-548-2722
Fax Number	:	818-548-2723

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	BETTY DE BORJA
Credential	:
Telephone Number	:	818-548-2722

Provider Enumeration Date	:	10/23/2018
Last Update Date	:	10/23/2018

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