Provider Demographics
NPI:1114782471
Name:HEALING HOMECARE AGENCY LLC
Entity Type:Organization
Organization Name:HEALING HOMECARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:QUOC
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-481-8006
Mailing Address - Street 1:925 S ATLANTIC BLVD STE 205A
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-1097
Mailing Address - Country:US
Mailing Address - Phone:626-628-0515
Mailing Address - Fax:626-537-1004
Practice Address - Street 1:925 S ATLANTIC BLVD STE 205A
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1097
Practice Address - Country:US
Practice Address - Phone:626-628-0515
Practice Address - Fax:626-537-1004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care