Organization
INDIVIDUAL CARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEREMIAH WILLIAMS II (OWNER)
(310) 795-5839
Entity
Organization
Contact information
Practice address
13488 MAXELLA AVE, UNIT 311, MARINA DEL REY, CA 90292-4300
(310) 795-5839
Mailing address
13488 MAXELLA AVE, UNIT 311, MARINA DEL REY, CA 90292-4300
(310) 795-5839
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
04/22/2014
Last updated
04/22/2014
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