Provider Demographics
NPI:1467536664
Name:CENTRAL HOME HEALTH CARE INC.
Entity Type:Organization
Organization Name:CENTRAL HOME HEALTH CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELEONIDA
Authorized Official - Middle Name:P
Authorized Official - Last Name:PERIDO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:818-500-1254
Mailing Address - Street 1:1016 E BROADWAY ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-4536
Mailing Address - Country:US
Mailing Address - Phone:818-500-1254
Mailing Address - Fax:818-500-1279
Practice Address - Street 1:1016 E BROADWAY
Practice Address - Street 2:SUITE 205
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-4532
Practice Address - Country:US
Practice Address - Phone:818-500-1254
Practice Address - Fax:818-500-1279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980001501251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA058273Medicare ID - Type UnspecifiedHOME HEALTH PROVIDER NO.