Provider Demographics
NPI:1689658049
Name:CAREMAX HOME HEALTH SERVICES INC
Entity Type:Organization
Organization Name:CAREMAX HOME HEALTH SERVICES INC
Other - Org Name:CAREMAX HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NIMFA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMBULAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:818-920-9255
Mailing Address - Street 1:8953 WOODMAN AVE
Mailing Address - Street 2:# 102
Mailing Address - City:ARLETA
Mailing Address - State:CA
Mailing Address - Zip Code:91331-6491
Mailing Address - Country:US
Mailing Address - Phone:818-920-9255
Mailing Address - Fax:818-920-3190
Practice Address - Street 1:8953 WOODMAN AVE
Practice Address - Street 2:# 102
Practice Address - City:ARLETA
Practice Address - State:CA
Practice Address - Zip Code:91331-6457
Practice Address - Country:US
Practice Address - Phone:818-920-9255
Practice Address - Fax:818-920-3190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-30
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980001038251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHHA57789FMedicaid
557789Medicare Oscar/Certification