Provider Demographics
NPI:1114182870
Name:HEARTEN HOME HEALTH, INC.
Entity Type:Organization
Organization Name:HEARTEN HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:ANUSIEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-578-2327
Mailing Address - Street 1:1720 E LOS ANGELES AVE
Mailing Address - Street 2:SUITE 217
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-2057
Mailing Address - Country:US
Mailing Address - Phone:805-578-2327
Mailing Address - Fax:805-578-9327
Practice Address - Street 1:1720 E LOS ANGELES AVE
Practice Address - Street 2:SUITE 217
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-2057
Practice Address - Country:US
Practice Address - Phone:805-578-2327
Practice Address - Fax:805-578-9327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-22
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550000910251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA059088Medicare Oscar/Certification