Provider Demographics
NPI:1467861096
Name:SECOND WIND HOME HEALTH, INC.
Entity Type:Organization
Organization Name:SECOND WIND HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CFO/SECRETARY
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:TERESA
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-872-0262
Mailing Address - Street 1:100 N BARRANCA ST STE 910
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91791-1634
Mailing Address - Country:US
Mailing Address - Phone:626-872-0262
Mailing Address - Fax:626-872-0263
Practice Address - Street 1:100 N BARRANCA ST STE 910
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91791-1634
Practice Address - Country:US
Practice Address - Phone:626-872-0262
Practice Address - Fax:626-872-0263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-07
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health