Provider Demographics
NPI:1750051942
Name:MEMORIAL HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:MEMORIAL HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARGARITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEROBYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-287-6990
Mailing Address - Street 1:8345 RESEDA BLVD STE 109
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-5925
Mailing Address - Country:US
Mailing Address - Phone:818-287-6990
Mailing Address - Fax:
Practice Address - Street 1:8345 RESEDA BLVD STE 109
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-5925
Practice Address - Country:US
Practice Address - Phone:818-287-6990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUPREME MEDICAL CARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-17
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health