Provider Demographics
NPI:1669865630
Name:NIVIE HOME HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:NIVIE HOME HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MAGDALENE
Authorized Official - Middle Name:
Authorized Official - Last Name:AGBOGHIDI
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:951-488-9000
Mailing Address - Street 1:23800 SUNNYMEAD BLVD STE H
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92553-7731
Mailing Address - Country:US
Mailing Address - Phone:951-488-9000
Mailing Address - Fax:
Practice Address - Street 1:23800 SUNNYMEAD BLVD
Practice Address - Street 2:SUITE H
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-0536
Practice Address - Country:US
Practice Address - Phone:951-488-9000
Practice Address - Fax:951-346-4000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-13
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA184284251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health