Organization
A FRIEND FOR LIFE LLC
Active
Other names
SENIOR HELPERS OF SAN DIEGO
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID WALLACE (OPERATING MEMBER)
(619) 450-4686
Entity
Organization
Contact information
Practice address
928 FORT STOCKTON DR STE 205, SAN DIEGO, CA 92103-1893
(619) 450-4686
(619) 450-4689
Mailing address
928 FORT STOCKTON DR STE 205, SAN DIEGO, CA 92103-1893
(619) 450-4686
(619) 450-4689
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
374700018
STATE OF CALIFORNIA HOME CARE SERVICES BUREAU
CA
Enumeration date
04/03/2019
Last updated
03/10/2021
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