Provider Demographics
NPI:1194029413
Name:FIRST RESPONSE HOME CARE, INC.
Entity Type:Organization
Organization Name:FIRST RESPONSE HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:VERDIYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-566-1605
Mailing Address - Street 1:4730 WOODMAN AVE STE 430
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-2450
Mailing Address - Country:US
Mailing Address - Phone:818-566-1605
Mailing Address - Fax:818-566-1606
Practice Address - Street 1:4730 WOODMAN AVE STE 430
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-2450
Practice Address - Country:US
Practice Address - Phone:818-566-1605
Practice Address - Fax:818-566-1606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-29
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550001571251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA059429Medicare Oscar/Certification