Provider Demographics
NPI:1639800378
Name:SIGNATURE CARE PROVIDER LLC
Entity Type:Organization
Organization Name:SIGNATURE CARE PROVIDER LLC
Other - Org Name:HOME HELPERS HOME CARE OF NORTH CALABASAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LABA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSNAWI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-752-4538
Mailing Address - Street 1:18401 BURBANK BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-6619
Mailing Address - Country:US
Mailing Address - Phone:440-752-4538
Mailing Address - Fax:
Practice Address - Street 1:18401 BURBANK BLVD STE 220
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-6619
Practice Address - Country:US
Practice Address - Phone:440-752-4538
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-22
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care