Provider Demographics
NPI:1053471847
Name:HIGH QUALITY HOME HEALTH AGENCY, INC.
Entity Type:Organization
Organization Name:HIGH QUALITY HOME HEALTH AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:L
Authorized Official - Last Name:LAGLEVA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:323-954-8102
Mailing Address - Street 1:21707 HAWTHORNE BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-7012
Mailing Address - Country:US
Mailing Address - Phone:323-954-8102
Mailing Address - Fax:323-954-8114
Practice Address - Street 1:21707 HAWTHORNE BLVD STE 202
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-7012
Practice Address - Country:US
Practice Address - Phone:323-954-8102
Practice Address - Fax:323-954-8114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980001609251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA058346OtherMEDICARE PROVIDER NUMBER
CAHHA08346FMedicaid
CAHHA08346FMedicaid