# GROUPO AQUILA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Extended Healthcare Systems
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669179206
- **Authorized official:** DAMON F CLARK (PRESIDENT)
- **Authorized official phone:** (213) 380-1399

## Contact information

- **Practice address:** 400 CORPORATE POINTE STE 300, CULVER CITY, CA 90230-7620
- **Practice address phone:** (213) 380-1399
- **Practice address fax:** (213) 380-4046
- **Mailing address:** 400 CORPORATE POINTE STE 300, CULVER CITY, CA 90230-7620
- **Mailing address phone:** (213) 380-1399

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 02/14/2023
- **Last updated:** 08/15/2024