Provider Demographics
NPI:1578947347
Name:ARDMORE HOME CARE LLC
Entity Type:Organization
Organization Name:ARDMORE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:SARMIENTO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:213-255-8390
Mailing Address - Street 1:128 N ARDMORE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90004-4502
Mailing Address - Country:US
Mailing Address - Phone:213-674-7046
Mailing Address - Fax:213-674-7046
Practice Address - Street 1:128 N ARDMORE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004-4502
Practice Address - Country:US
Practice Address - Phone:213-674-7046
Practice Address - Fax:213-674-7046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-12
Last Update Date:2015-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA197608676310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility