Provider Demographics
NPI:1043782576
Name:ORIGINS HOME HEALTH CARE INC.
Entity Type:Organization
Organization Name:ORIGINS HOME HEALTH CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPANY OWNER - CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUANITA SHIRLEY
Authorized Official - Middle Name:VILLEGAS
Authorized Official - Last Name:TANUYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-393-2020
Mailing Address - Street 1:PO BOX 224
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630
Mailing Address - Country:US
Mailing Address - Phone:714-393-2020
Mailing Address - Fax:657-371-5017
Practice Address - Street 1:137 1/2 S SO KNOTT
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804
Practice Address - Country:US
Practice Address - Phone:657-371-5018
Practice Address - Fax:657-371-5017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-21
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health