Provider Demographics
NPI:1477785806
Name:CAVALRY HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:CAVALRY HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ROWENA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELEGADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-473-0395
Mailing Address - Street 1:818 W CAMERON AVE
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-4136
Mailing Address - Country:US
Mailing Address - Phone:626-473-0395
Mailing Address - Fax:626-209-0341
Practice Address - Street 1:818 W CAMERON AVE
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-4136
Practice Address - Country:US
Practice Address - Phone:626-473-0395
Practice Address - Fax:626-209-0341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-19
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA550001144OtherFACILITY LICENSE