Provider Demographics
NPI:1487032546
Name:GRANDE HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:GRANDE HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHARINA JOBELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:818-845-2000
Mailing Address - Street 1:1419 N SAN FERNANDO BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-4100
Mailing Address - Country:US
Mailing Address - Phone:818-845-2000
Mailing Address - Fax:818-848-1788
Practice Address - Street 1:1419 N SAN FERNANDO BLVD STE 220
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91504-4100
Practice Address - Country:US
Practice Address - Phone:818-845-2000
Practice Address - Fax:818-848-1788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-09
Last Update Date:2015-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health