Provider Demographics
NPI:1508072034
Name:BRAEWOOD HOME HEALTH, INC.
Entity Type:Organization
Organization Name:BRAEWOOD HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:RAY
Authorized Official - Middle Name:ARCILLA
Authorized Official - Last Name:PANIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-641-1444
Mailing Address - Street 1:8215 VAN NUYS BLVD STE 300-301
Mailing Address - Street 2:
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-4810
Mailing Address - Country:US
Mailing Address - Phone:818-641-1444
Mailing Address - Fax:818-641-1444
Practice Address - Street 1:8215 VAN NUYS BLVD STE 300-301
Practice Address - Street 2:
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402
Practice Address - Country:US
Practice Address - Phone:818-641-1444
Practice Address - Fax:818-641-1444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health