Provider Demographics
NPI:1285227082
Name:SHEMEN HOME HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:SHEMEN HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:FAVOUR
Authorized Official - Middle Name:I
Authorized Official - Last Name:ERUNOMASE
Authorized Official - Suffix:
Authorized Official - Credentials:CSCM
Authorized Official - Phone:510-359-8198
Mailing Address - Street 1:1101 MARINA VILLAGE PKWY STE 201
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-6472
Mailing Address - Country:US
Mailing Address - Phone:510-402-4646
Mailing Address - Fax:
Practice Address - Street 1:1101 MARINA VILLAGE PKWY STE 201
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-6472
Practice Address - Country:US
Practice Address - Phone:510-402-4646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-12
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care