Provider Demographics
NPI:1619667243
Name:AG HOME HEALTH
Entity Type:Organization
Organization Name:AG HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:NELSON
Authorized Official - Last Name:VITUG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-362-6008
Mailing Address - Street 1:12631 IMPERIAL HWY
Mailing Address - Street 2:BLDG D SUITE 126B
Mailing Address - City:SANTA FE SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:90670
Mailing Address - Country:US
Mailing Address - Phone:562-362-6008
Mailing Address - Fax:
Practice Address - Street 1:12631 IMPERIAL HWY
Practice Address - Street 2:BLDG D SUITE 126B
Practice Address - City:SANTA FE SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:90670
Practice Address - Country:US
Practice Address - Phone:562-362-6008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health