Provider Demographics
NPI:1053052886
Name:IMMACULATE HANDS CARE LLC
Entity Type:Organization
Organization Name:IMMACULATE HANDS CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLS
Authorized Official - Middle Name:
Authorized Official - Last Name:DELOS SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-746-6963
Mailing Address - Street 1:1425 W SPRING ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90810-2822
Mailing Address - Country:US
Mailing Address - Phone:310-746-6963
Mailing Address - Fax:562-513-3446
Practice Address - Street 1:1425 W SPRING ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90810-2822
Practice Address - Country:US
Practice Address - Phone:310-746-6963
Practice Address - Fax:562-513-3446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility