Provider Demographics
NPI:1376025650
Name:RDA HOME HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:RDA HOME HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RODELIO
Authorized Official - Middle Name:D
Authorized Official - Last Name:AMANTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-426-3140
Mailing Address - Street 1:11217 WILBUR AVE
Mailing Address - Street 2:
Mailing Address - City:PORTER RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91326-2466
Mailing Address - Country:US
Mailing Address - Phone:661-426-3140
Mailing Address - Fax:661-322-7771
Practice Address - Street 1:2130 N ARROWHEAD AVE STE 200
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92405-4023
Practice Address - Country:US
Practice Address - Phone:661-426-3140
Practice Address - Fax:661-322-7771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-03
Last Update Date:2018-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1790125946Medicaid