Provider Demographics
NPI:1295037992
Name:ETERNITY HOME HEALTH, INC.
Entity Type:Organization
Organization Name:ETERNITY HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERNOBELSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-337-8699
Mailing Address - Street 1:15859 EDNA PLACE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:IRWINDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91706-2153
Mailing Address - Country:US
Mailing Address - Phone:626-337-8699
Mailing Address - Fax:626-337-8689
Practice Address - Street 1:15859 EDNA PLACE
Practice Address - Street 2:SUITE 111
Practice Address - City:IRWINDALE
Practice Address - State:CA
Practice Address - Zip Code:91706-2153
Practice Address - Country:US
Practice Address - Phone:626-337-8699
Practice Address - Fax:626-337-8689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health