Provider Demographics
NPI:1699811570
Name:MOBILITY HOME HEALTH SERVICES,INC.
Entity Type:Organization
Organization Name:MOBILITY HOME HEALTH SERVICES,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:MONA LIZA
Authorized Official - Middle Name:B
Authorized Official - Last Name:DELMENDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-772-2910
Mailing Address - Street 1:8619 RESEDA BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-4044
Mailing Address - Country:US
Mailing Address - Phone:818-772-2910
Mailing Address - Fax:818-772-8361
Practice Address - Street 1:8619 RESEDA BLVD.
Practice Address - Street 2:SUITE 205
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324
Practice Address - Country:US
Practice Address - Phone:818-772-2910
Practice Address - Fax:818-772-8361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2010-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550000282251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA550000282OtherSTATE LICENSE HOME HEALTH
CA550000282OtherSTATE LICENSE HOME HEALTH