Provider Demographics
NPI:1528541935
Name:VIRA HOME CARE
Entity Type:Organization
Organization Name:VIRA HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:DIEGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-873-2711
Mailing Address - Street 1:235 N MOORPARK RD # A-1481
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-4311
Mailing Address - Country:US
Mailing Address - Phone:805-873-2711
Mailing Address - Fax:
Practice Address - Street 1:3200 GOLF COURSE DR # 205
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-7696
Practice Address - Country:US
Practice Address - Phone:805-873-2711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-11
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care