Provider Demographics
NPI:1184276768
Name:STAND SURE HOME CARE INC.
Entity type:Organization
Organization Name:STAND SURE HOME CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:VANKOUWENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-206-8121
Mailing Address - Street 1:17750 SHERMAN WAY STE 310
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-8332
Mailing Address - Country:US
Mailing Address - Phone:818-206-8121
Mailing Address - Fax:818-975-8260
Practice Address - Street 1:17750 SHERMAN WAY STE 310
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-8332
Practice Address - Country:US
Practice Address - Phone:818-206-8121
Practice Address - Fax:818-975-8260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-12
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care