Provider Demographics
NPI:1619739653
Name:MAGGZ ADULT BUDDY CARE
Entity Type:Organization
Organization Name:MAGGZ ADULT BUDDY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:BROWN DELANEY
Authorized Official - Suffix:
Authorized Official - Credentials:CNO
Authorized Official - Phone:818-914-8961
Mailing Address - Street 1:5850 CANOGA AVE
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-6505
Mailing Address - Country:US
Mailing Address - Phone:424-944-5983
Mailing Address - Fax:
Practice Address - Street 1:22938 AVENUE SAN LUIS
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2825
Practice Address - Country:US
Practice Address - Phone:818-914-8961
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MAAGZ ADULT BUDDY CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health