MEDICARE: MY NEIGHBORS HELPER OF CALIFORNIA LLC

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1407294069
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MY NEIGHBORS HELPER OF CALIFORNIA LLC

Provider Business Mailing Address
First Line	:	4252 W 64TH ST
Second Line	:
City	:	INGLEWOOD
State	:	CA
Zip	:	90302-1333
Country	:	US
Telephone Number	:	323-533-7279
Fax Number	:

Provider Business Practice Location Address
First Line	:	4252 W 64TH ST
Second Line	:
City	:	INGLEWOOD
State	:	CA
Zip	:	90302-1333
Country	:	US
Telephone Number	:	323-533-7279
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. DAPHNE RENEA MCCLENDON
Credential	:
Telephone Number	:	323-533-7279

Provider Enumeration Date	:	06/05/2013
Last Update Date	:	06/05/2013

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