Provider Demographics
NPI:1528202819
Name:SERAPHIM CARE HOME HEALTH AGENCY
Entity Type:Organization
Organization Name:SERAPHIM CARE HOME HEALTH AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHUCK SERAFIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:ABELLON
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:626-376-0361
Mailing Address - Street 1:4780 W MISSION BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MONTCLAIR
Mailing Address - State:CA
Mailing Address - Zip Code:91762
Mailing Address - Country:US
Mailing Address - Phone:626-376-0361
Mailing Address - Fax:909-348-7181
Practice Address - Street 1:4780 W MISSION BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91762
Practice Address - Country:US
Practice Address - Phone:626-376-0361
Practice Address - Fax:909-348-7181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-30
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health