Provider Demographics
NPI:1629965926
Name:VSC HBO, LLC
Entity type:Organization
Organization Name:VSC HBO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERTA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:CONSOLVER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:714-289-2400
Mailing Address - Street 1:393 S TUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92866-2501
Mailing Address - Country:US
Mailing Address - Phone:714-289-2400
Mailing Address - Fax:714-289-2367
Practice Address - Street 1:393 S TUSTIN ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-2501
Practice Address - Country:US
Practice Address - Phone:714-289-2400
Practice Address - Fax:714-289-2367
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VSC HBO, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-06-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric