Provider Demographics
NPI:1003029059
Name:COURTNEY HOME CARE SERVICES INC.
Entity Type:Organization
Organization Name:COURTNEY HOME CARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR DPCS
Authorized Official - Prefix:MS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:URIETA
Authorized Official - Last Name:LIEN
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:818-998-2407
Mailing Address - Street 1:21825 NORDHOFF ST
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-5712
Mailing Address - Country:US
Mailing Address - Phone:818-998-5011
Mailing Address - Fax:818-885-5830
Practice Address - Street 1:21825 NORDHOFF ST
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-5712
Practice Address - Country:US
Practice Address - Phone:818-998-5011
Practice Address - Fax:818-885-5830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980001013251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA557687Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
CA980001013Medicare UPIN