Provider Demographics
NPI:1508273558
Name:GOOD SHEPHERD HOME HEALTH LLC
Entity Type:Organization
Organization Name:GOOD SHEPHERD HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CARLOTA
Authorized Official - Middle Name:ROBLES
Authorized Official - Last Name:ESPINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-400-5750
Mailing Address - Street 1:18623 VENTURA BLVD. SUITE 205
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-6802
Mailing Address - Country:US
Mailing Address - Phone:818-578-6095
Mailing Address - Fax:818-578-6010
Practice Address - Street 1:18623 VENTURA BLVD. SUITE 205
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-6802
Practice Address - Country:US
Practice Address - Phone:818-578-6095
Practice Address - Fax:818-578-6010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-22
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health