Provider Demographics
NPI:1427180611
Name:INGLEWOOD HOME HEALTH CARE AGENCY
Entity Type:Organization
Organization Name:INGLEWOOD HOME HEALTH CARE AGENCY
Other - Org Name:INGLEWOOD HOME HEALTH CARE AGENCY, INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:GROSPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-677-1114
Mailing Address - Street 1:101 N LA BREA AVE
Mailing Address - Street 2:SUITE 604
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301-1769
Mailing Address - Country:US
Mailing Address - Phone:310-677-1114
Mailing Address - Fax:310-677-1115
Practice Address - Street 1:14015 VAN NESS AVE STE 7
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90249-2937
Practice Address - Country:US
Practice Address - Phone:310-677-1114
Practice Address - Fax:310-677-1115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48237267251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHHA08103FMedicaid
CA058103Medicare Oscar/Certification