Provider Demographics
NPI:1437793429
Name:AMERICAN GERIATRIC CARE MANAGEMENT INC.
Entity Type:Organization
Organization Name:AMERICAN GERIATRIC CARE MANAGEMENT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-619-0940
Mailing Address - Street 1:22102 NORMANDIE AVE
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-2254
Mailing Address - Country:US
Mailing Address - Phone:310-619-0940
Mailing Address - Fax:
Practice Address - Street 1:22102 NORMANDIE AVE
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-2254
Practice Address - Country:US
Practice Address - Phone:310-619-0940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-01
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA192700204OtherHCO REGISTRATION NUMBER