Provider Demographics
NPI:1033591912
Name:SOVEREIGN HOME HEALTH CARE AGENCY, INC.
Entity Type:Organization
Organization Name:SOVEREIGN HOME HEALTH CARE AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHIBUZO
Authorized Official - Middle Name:BLESSING
Authorized Official - Last Name:ANUSIEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-943-4600
Mailing Address - Street 1:15707 IMPERIAL HWY
Mailing Address - Street 2:SUITE D
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-2511
Mailing Address - Country:US
Mailing Address - Phone:562-943-4600
Mailing Address - Fax:562-943-4611
Practice Address - Street 1:15707 IMPERIAL HWY
Practice Address - Street 2:SUITE D
Practice Address - City:LA MIRADA
Practice Address - State:CA
Practice Address - Zip Code:90638-2511
Practice Address - Country:US
Practice Address - Phone:562-943-4600
Practice Address - Fax:562-943-4611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-26
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health