Provider Demographics
NPI:1629354808
Name:EXECUTIVE HOME HEALTH, INC
Entity Type:Organization
Organization Name:EXECUTIVE HOME HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:FRAIPONT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-765-9202
Mailing Address - Street 1:750 S RAYMOND AVE
Mailing Address - Street 2:SUITE 123
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91109-3244
Mailing Address - Country:US
Mailing Address - Phone:626-765-9202
Mailing Address - Fax:626-765-9206
Practice Address - Street 1:750 S RAYMOND AVE
Practice Address - Street 2:SUITE 123
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3244
Practice Address - Country:US
Practice Address - Phone:626-765-9202
Practice Address - Fax:626-765-9206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-01
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health