Provider Demographics
NPI:1437576808
Name:TWIN HEARTS CARE HOME
Entity Type:Organization
Organization Name:TWIN HEARTS CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:EMI
Authorized Official - Middle Name:TAMAYO
Authorized Official - Last Name:BARENG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-446-0920
Mailing Address - Street 1:5803 TROOST AVE
Mailing Address - Street 2:
Mailing Address - City:N HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601-1032
Mailing Address - Country:US
Mailing Address - Phone:213-446-0920
Mailing Address - Fax:818-710-8758
Practice Address - Street 1:5803 TROOST AVE
Practice Address - Street 2:
Practice Address - City:N HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91601-1032
Practice Address - Country:US
Practice Address - Phone:213-446-0920
Practice Address - Fax:818-710-8758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-24
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA197608144302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization