Provider Demographics
NPI:1326679325
Name:SOUTHLAND HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:SOUTHLAND HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RUBERN
Authorized Official - Middle Name:
Authorized Official - Last Name:GARIBYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-650-7745
Mailing Address - Street 1:3169 BARBARA CT STE G
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90068-1700
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3169 BARBARA CT STE G
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90068-1700
Practice Address - Country:US
Practice Address - Phone:818-650-7745
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health