Provider Demographics
NPI:1275009102
Name:HSERVICES 5505, INC
Entity Type:Organization
Organization Name:HSERVICES 5505, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:HULL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-799-4855
Mailing Address - Street 1:1000 E WALNUT ST STE 228
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-5312
Mailing Address - Country:US
Mailing Address - Phone:626-799-4855
Mailing Address - Fax:
Practice Address - Street 1:1000 E WALNUT ST STE 228
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-5312
Practice Address - Country:US
Practice Address - Phone:626-799-4855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care