1528651676 NPI number — DONNESSTO HOME CARE LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528651676 NPI number — DONNESSTO HOME CARE LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DONNESSTO HOME CARE LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528651676
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/19/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
28368 CONSTELLATION RD #360
Provider Second Line Business Mailing Address:
SUITE 208
Provider Business Mailing Address City Name:
SANTA CLARITA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91355-5005
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-583-0115
Provider Business Mailing Address Fax Number:
661-583-0121

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
28368 CONSTELLATION RD #360
Provider Second Line Business Practice Location Address:
SUITE 208
Provider Business Practice Location Address City Name:
SANTA CLARITA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91355-5005
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-583-0115
Provider Business Practice Location Address Fax Number:
661-583-0121
Provider Enumeration Date:
02/18/2021

Additional Information

Authorized Official

Authorized Official Last Name:
ORTEGA
Authorized Official First Name:
ERNESTO
Authorized Official Middle Name:
Authorized Official Title or Position:
GENERAL MANAGER - OWNER
Authorized Official Telephone Number:
661-583-0115

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 194700631 . This is a "CALIFORNIA CDSS HOME CARE ORGANIZATION LICENSE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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