Mt. Zion Care Speciale, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

200318210050 Issued in CA

Legal business name

MT. ZION CARE SPECIALE, LLC

Practice address

4643 Beverly Blvd
Los Angeles, CA 90004-3101

Phone

(323) 461-0588

Fax

(323) 461-0432

NPI assigned

Jan 5, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Virginia Sotelo Dolar, B.S. IN BUSINESS ADM

Title

Executive Director

Phone

(626) 864-8854

Specialties & licenses 1

Addresses

Other names 1

• Mt. Zion Other name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467500694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 CARLOS ST",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918034432",
            "telephone_number": "626-864-8854",
            "fax_number": "323-461-0432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4643 BEVERLY BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900043101",
            "telephone_number": "323-461-0588",
            "fax_number": "323-461-0432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT. ZION CARE SPECIALE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DOLAR",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_middle_name": "SOTELO",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "626-864-8854",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "B.S. IN BUSINESS ADM"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "200318210050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mt. Zion",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.