Provider Demographics
NPI:1164614244
Name:MAHARLIKA HEALTHCARE SERVICES, INC.
Entity Type:Organization
Organization Name:MAHARLIKA HEALTHCARE SERVICES, INC.
Other - Org Name:AMBIANCE HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARCELO
Authorized Official - Middle Name:G
Authorized Official - Last Name:CARABAJAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-859-7163
Mailing Address - Street 1:2829 N GLENOAKS BLVD
Mailing Address - Street 2:STE 204
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-2661
Mailing Address - Country:US
Mailing Address - Phone:818-859-7163
Mailing Address - Fax:818-859-7165
Practice Address - Street 1:2829 N GLENOAKS BLVD
Practice Address - Street 2:STE 204
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91504-2661
Practice Address - Country:US
Practice Address - Phone:818-859-7163
Practice Address - Fax:818-859-7165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-13
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980001401251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA058464Medicare Oscar/Certification