Provider Demographics
NPI:1346523784
Name:OLIVE HOME HEALTH CENTER INC
Entity Type:Organization
Organization Name:OLIVE HOME HEALTH CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EKATTE
Authorized Official - Middle Name:
Authorized Official - Last Name:ITON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-751-7000
Mailing Address - Street 1:2222 W MANCHESTER BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90305-2529
Mailing Address - Country:US
Mailing Address - Phone:323-751-7000
Mailing Address - Fax:
Practice Address - Street 1:2222 W MANCHESTER BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90305-2524
Practice Address - Country:US
Practice Address - Phone:323-751-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-22
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health