Dequincy K Adderly, MSW

Individual provider Active NPI Home Health Agency · Reseda, CA

NPI 1124332077 · NPPES record last updated Aug 3, 2010

Key facts

NPI
1124332077
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Agency 251E00000X
Practice address
7101 Baird Ave
Reseda, CA 91335-4150
Phone
(818) 342-5897
Fax
(818) 975-5008
NPI assigned
Aug 3, 2010
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Yes

Addresses

Primary practice location

7101 Baird Ave
Reseda, CA 91335-4150

Mailing address

7101 Baird Ave
Reseda, CA 91335-4150
Phone (818) 342-5897

Other providers in Reseda, CA

All providers in Reseda, CA · Home Health Agency in California

Sources for this page

Verify at the official NPI Registry.