Provider Demographics
NPI:1225274889
Name:A AND S HOME CARE VILLA INC.
Entity Type:Organization
Organization Name:A AND S HOME CARE VILLA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:BROWN
Authorized Official - Last Name:EZEUKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-709-7179
Mailing Address - Street 1:21211 LEMARSH ST
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-3016
Mailing Address - Country:US
Mailing Address - Phone:818-709-7179
Mailing Address - Fax:818-709-4195
Practice Address - Street 1:21211 LEMARSH ST
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-3016
Practice Address - Country:US
Practice Address - Phone:818-709-7179
Practice Address - Fax:818-709-4195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-31
Last Update Date:2008-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA197607167310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility