Provider Demographics
NPI:1477584126
Name:FINE HOME HEALTH, INC.
Entity Type:Organization
Organization Name:FINE HOME HEALTH, INC.
Other - Org Name:HOMEREACH HOSPICE & NURSING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LYDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:562-424-9405
Mailing Address - Street 1:2250 OBISPO AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:SIGNAL HILL
Mailing Address - State:CA
Mailing Address - Zip Code:90755-4027
Mailing Address - Country:US
Mailing Address - Phone:562-424-9405
Mailing Address - Fax:562-988-6831
Practice Address - Street 1:2250 OBISPO AVE STE 101
Practice Address - Street 2:
Practice Address - City:SIGNAL HILL
Practice Address - State:CA
Practice Address - Zip Code:90755-4027
Practice Address - Country:US
Practice Address - Phone:562-424-9405
Practice Address - Fax:562-988-6831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHPC01731F251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHPC01731FMedicaid
05-1731Medicare ID - Type Unspecified