Provider Demographics
NPI:1396809232
Name:GOOD WILL PLUS INCORPORATED
Entity type:Organization
Organization Name:GOOD WILL PLUS INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MA ALMA
Authorized Official - Middle Name:VELASCO
Authorized Official - Last Name:CALUAG
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:323-725-7620
Mailing Address - Street 1:233 E POMONA BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91755-7226
Mailing Address - Country:US
Mailing Address - Phone:323-725-7620
Mailing Address - Fax:323-725-7864
Practice Address - Street 1:233 E POMONA BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91755-7226
Practice Address - Country:US
Practice Address - Phone:323-725-7620
Practice Address - Fax:323-725-7864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550000299251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1396809232Medicaid
CA1396809232Medicaid
CAHH630008401Medicare Oscar/Certification