Provider Demographics
NPI:1639209257
Name:TOTAL HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:TOTAL HEALTHCARE SERVICES
Other - Org Name:TOTAL HEALTHCARE AGENCY
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:MR
Authorized Official - First Name:ADONIS
Authorized Official - Middle Name:
Authorized Official - Last Name:OGBENI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:310-508-7083
Mailing Address - Street 1:302 E MANCHESTER BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301-1815
Mailing Address - Country:US
Mailing Address - Phone:310-508-7083
Mailing Address - Fax:
Practice Address - Street 1:302 E MANCHESTER BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-1815
Practice Address - Country:US
Practice Address - Phone:310-508-7083
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA696188302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization