Organization
BIG VINE HOME HEALTH SERVICES, INC
Active
Other names
Big Vine Home Health Services, Inc, Big Vine Home Health Services, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
JI HOON KIM (CEO)
(626) 315-8913
Entity
Organization
Contact information
Practice address
8220 KATELLA AVE STE 218, STANTON, CA 90680-3294
(714) 622-5338
Mailing address
8220 KATELLA AVE STE 218, STANTON, CA 90680-3294
(714) 622-5338
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30965
BUSINESS LICENSE NUMBER
CA
Enumeration date
11/28/2018
Last updated
11/28/2018
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