A Friend for Life LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

A FRIEND FOR LIFE LLC

Practice address

928 Fort Stockton Dr Ste 205
San Diego, CA 92103-1893

Phone

(619) 450-4686

Fax

(619) 450-4689

NPI assigned

Apr 3, 2019

Organization subpart

No

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

Authorized official

Name

Mr. David Wallace

Title

Operating Member

Phone

(619) 450-4686

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• SENIOR HELPERS OF SAN DIEGO Doing business as

Locations

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

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615334400000",
    "number": "1669934055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 FORT STOCKTON DR STE 205",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921031893",
            "telephone_number": "619-450-4686",
            "fax_number": "619-450-4689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 FORT STOCKTON DR STE 205",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921031893",
            "telephone_number": "619-450-4686",
            "fax_number": "619-450-4689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A FRIEND FOR LIFE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-03",
        "last_updated": "2021-03-10",
        "certification_date": "2021-02-10",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OPERATING MEMBER",
        "authorized_official_telephone_number": "619-450-4686",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF CALIFORNIA HOME CARE SERVICES BUREAU",
            "identifier": "374700018",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SENIOR HELPERS OF SAN DIEGO",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SENIOR HELPERS OF SAN DIEGO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• In Home Supportive Care Agency in San Diego, CA
• Providers in San Diego, CA by specialty
• In Home Supportive Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; 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.