Provider Demographics
NPI:1528040284
Name:MC HOME HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:MC HOME HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:BALAUAG
Authorized Official - Last Name:CABICO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:626-854-1450
Mailing Address - Street 1:18800 AMAR RD
Mailing Address - Street 2:SUITE B-5
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-4166
Mailing Address - Country:US
Mailing Address - Phone:626-854-1450
Mailing Address - Fax:626-854-1451
Practice Address - Street 1:18800 AMAR RD
Practice Address - Street 2:SUITE B-5
Practice Address - City:WALNUT
Practice Address - State:CA
Practice Address - Zip Code:91789-4166
Practice Address - Country:US
Practice Address - Phone:626-854-1450
Practice Address - Fax:626-854-1451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-17
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA058172Medicare Oscar/Certification