Provider Demographics
NPI:1598449019
Name:COMPREHENSIVE CARE HOME HEALTH AGENCY INC.
Entity Type:Organization
Organization Name:COMPREHENSIVE CARE HOME HEALTH AGENCY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATIENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-908-4099
Mailing Address - Street 1:19112 GRIDLEY RD STE 200
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-6614
Mailing Address - Country:US
Mailing Address - Phone:562-526-4282
Mailing Address - Fax:
Practice Address - Street 1:19112 GRIDLEY RD STE 200
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-6614
Practice Address - Country:US
Practice Address - Phone:562-526-4282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health