Provider Demographics
NPI:1053440883
Name:DEVOTED HOME HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:DEVOTED HOME HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BONIFER
Authorized Official - Middle Name:PUNO
Authorized Official - Last Name:PARUNGAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-368-5759
Mailing Address - Street 1:17714 CHATSWORTH ST
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-5603
Mailing Address - Country:US
Mailing Address - Phone:818-368-5759
Mailing Address - Fax:
Practice Address - Street 1:17714 CHATSWORTH ST
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-5603
Practice Address - Country:US
Practice Address - Phone:818-368-5759
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA058151Medicare Oscar/Certification