Provider Demographics
NPI:1679758403
Name:PRIVILEGE HOME SERVICES, INC.
Entity Type:Organization
Organization Name:PRIVILEGE HOME SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KIM-PHUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:NGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-468-0888
Mailing Address - Street 1:11395 183RD ST
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-5434
Mailing Address - Country:US
Mailing Address - Phone:562-468-0888
Mailing Address - Fax:562-468-0889
Practice Address - Street 1:11395 183RD ST
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-5434
Practice Address - Country:US
Practice Address - Phone:562-468-0888
Practice Address - Fax:562-468-0889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-28
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550001022251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health