Provider Demographics
NPI:1518119346
Name:CARITAS HOME HEALTH PROVIDERS INC.
Entity Type:Organization
Organization Name:CARITAS HOME HEALTH PROVIDERS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:J
Authorized Official - Last Name:HATCH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:818-719-0296
Mailing Address - Street 1:22122 SHERMAN WAY
Mailing Address - Street 2:SUITE 308
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-1140
Mailing Address - Country:US
Mailing Address - Phone:818-719-0296
Mailing Address - Fax:818-881-1180
Practice Address - Street 1:22122 SHERMAN WAY
Practice Address - Street 2:SUITE 308
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-1140
Practice Address - Country:US
Practice Address - Phone:818-719-0296
Practice Address - Fax:818-881-1180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-10
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550000942251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5080105Medicare Oscar/Certification