Provider Demographics
NPI:1720520281
Name:W.A.Y.S HOME CARE & HEALTH AGENCY, LLC
Entity Type:Organization
Organization Name:W.A.Y.S HOME CARE & HEALTH AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:KEDRIN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-702-5222
Mailing Address - Street 1:8617 CRENSHAW BLVD
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90305-2330
Mailing Address - Country:US
Mailing Address - Phone:888-271-9297
Mailing Address - Fax:424-702-5222
Practice Address - Street 1:1620 CENTINELA AVE
Practice Address - Street 2:STE. 306
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90302-1045
Practice Address - Country:US
Practice Address - Phone:424-702-5222
Practice Address - Fax:424-702-5222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-14
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health