Provider Demographics
NPI:1578885372
Name:NEEDLES MEDICAL MANAGEMENT CENTER INC
Entity Type:Organization
Organization Name:NEEDLES MEDICAL MANAGEMENT CENTER INC
Other - Org Name:TRI-STATE HOME HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHEIF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RAFFI
Authorized Official - Middle Name:
Authorized Official - Last Name:KHARARJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-326-2217
Mailing Address - Street 1:1600 BAILEY AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:NEEDLES
Mailing Address - State:CA
Mailing Address - Zip Code:92363-3105
Mailing Address - Country:US
Mailing Address - Phone:760-326-2217
Mailing Address - Fax:760-326-2226
Practice Address - Street 1:1600 BAILEY AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:NEEDLES
Practice Address - State:CA
Practice Address - Zip Code:92363-3105
Practice Address - Country:US
Practice Address - Phone:760-326-2217
Practice Address - Fax:760-326-2226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-19
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health