Provider Demographics
NPI:1306029418
Name:OPTION ONE HOME CARE, INC.
Entity Type:Organization
Organization Name:OPTION ONE HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:RAJAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-719-8622
Mailing Address - Street 1:10120 CANOGA AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-3005
Mailing Address - Country:US
Mailing Address - Phone:818-719-8622
Mailing Address - Fax:818-710-1084
Practice Address - Street 1:7251 TOPANGA CANYON BLVD
Practice Address - Street 2:UNIT C2
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-1269
Practice Address - Country:US
Practice Address - Phone:818-719-8622
Practice Address - Fax:818-710-1084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-11
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA3028089OtherCA CORP. NUMBER
CA3028089OtherCA CORP. NUMBER