Provider Demographics
NPI:1356663033
Name:ASSURED INHOME CARE OF LOS ANGELES
Entity Type:Organization
Organization Name:ASSURED INHOME CARE OF LOS ANGELES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:
Authorized Official - Last Name:PRINCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1800-925-7159
Mailing Address - Street 1:12741 BELLFLOWER BLVD
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242-4800
Mailing Address - Country:US
Mailing Address - Phone:180-092-5715
Mailing Address - Fax:156-294-0193
Practice Address - Street 1:12741 BELLFLOWER BLVD
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-4800
Practice Address - Country:US
Practice Address - Phone:180-092-5715
Practice Address - Fax:156-294-0193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care