Provider Demographics
NPI:1891197687
Name:VISITING ANGELS OF LOS ANGELES
Entity Type:Organization
Organization Name:VISITING ANGELS OF LOS ANGELES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:YVETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:GEYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-291-0100
Mailing Address - Street 1:6709 LA TIJERA BLVD
Mailing Address - Street 2:#629
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-2017
Mailing Address - Country:US
Mailing Address - Phone:323-291-0100
Mailing Address - Fax:323-924-1175
Practice Address - Street 1:6709 LA TIJERA BLVD
Practice Address - Street 2:#629
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-2017
Practice Address - Country:US
Practice Address - Phone:323-291-0100
Practice Address - Fax:323-924-1175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-23
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA000221836600017311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home