Provider Demographics
NPI:1235319062
Name:JUBILEE HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:JUBILEE HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NIMFA
Authorized Official - Middle Name:C
Authorized Official - Last Name:SIMBULAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-578-9806
Mailing Address - Street 1:4195 VALLEY FAIR ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-2953
Mailing Address - Country:US
Mailing Address - Phone:805-578-9806
Mailing Address - Fax:
Practice Address - Street 1:4195 VALLEY FAIR ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-2953
Practice Address - Country:US
Practice Address - Phone:805-578-9806
Practice Address - Fax:805-578-4609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA3025180OtherCA CORP. NO.
CA059133Medicare PIN