Provider Demographics
NPI:1326117235
Name:FOUR P'S HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:FOUR P'S HEALTH SERVICES, INC.
Other - Org Name:COVENANT HOME HEALTH OF CALIFORNIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMELITA
Authorized Official - Middle Name:H
Authorized Official - Last Name:CUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-256-1111
Mailing Address - Street 1:1217 BUENA VISTA ST
Mailing Address - Street 2:SUITE 103-C
Mailing Address - City:DUARTE
Mailing Address - State:CA
Mailing Address - Zip Code:91010-2411
Mailing Address - Country:US
Mailing Address - Phone:626-256-1111
Mailing Address - Fax:626-256-1121
Practice Address - Street 1:1217 BUENA VISTA ST
Practice Address - Street 2:SUITE 103-C
Practice Address - City:DUARTE
Practice Address - State:CA
Practice Address - Zip Code:91010-2411
Practice Address - Country:US
Practice Address - Phone:626-256-1111
Practice Address - Fax:626-256-1121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
CA550000375251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health