Provider Demographics
NPI:1073727558
Name:JB & MM CONSULTING SERVICES, LLC DBA PACIFIC COAST HOME HEALTH SERVICE
Entity Type:Organization
Organization Name:JB & MM CONSULTING SERVICES, LLC DBA PACIFIC COAST HOME HEALTH SERVICE
Other - Org Name:PACIFIC COAST HOME HEALTH SERVICES, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR DPCS
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:626-416-3268
Mailing Address - Street 1:908 S. VILLAGE OAKS DRIVE
Mailing Address - Street 2:SUITE 200A
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91724
Mailing Address - Country:US
Mailing Address - Phone:626-416-3268
Mailing Address - Fax:626-416-3264
Practice Address - Street 1:908 S. VILLAGE OAKS DRIVE
Practice Address - Street 2:SUITE 200A
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91724
Practice Address - Country:US
Practice Address - Phone:818-748-3348
Practice Address - Fax:818-748-3343
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JB & MM CONSULTING SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-10
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1073727558Medicare UPIN