Provider Demographics
NPI:1235473604
Name:ALL HEART HOME HEALTH CARE OF CAMARILLO LLC
Entity Type:Organization
Organization Name:ALL HEART HOME HEALTH CARE OF CAMARILLO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:MADURO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:805-482-8689
Mailing Address - Street 1:400 MOBIL AVE
Mailing Address - Street 2:SUITE A1
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-6338
Mailing Address - Country:US
Mailing Address - Phone:805-482-8689
Mailing Address - Fax:805-322-3565
Practice Address - Street 1:400 MOBIL AVE
Practice Address - Street 2:SUITE A1
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-6338
Practice Address - Country:US
Practice Address - Phone:805-482-8689
Practice Address - Fax:805-322-3565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-25
Last Update Date:2012-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health