Organization
EPAK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK DWAYNE JACKSON II (ADMINISTRATOR)
(310) 999-8113
Entity
Organization
Contact information
Practice address
6327 GIOVANNI WAY, PALMDALE, CA 93551
(310) 999-8113
(661) 206-5039
Mailing address
6327 GIOVANNI WAY, PALMDALE, CA 93551
(310) 999-8113
(661) 206-5039
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
—
—
163WH1000X
Hospice Registered Nurse
—
—
Other
Enumeration date
08/16/2020
Last updated
08/16/2020
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