Provider Demographics
NPI:1790408276
Name:BOLA HOME HEALTH LLC
Entity Type:Organization
Organization Name:BOLA HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/TREASURER/SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:ADEPEJU
Authorized Official - Middle Name:B
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:916-883-2244
Mailing Address - Street 1:7275 E SOUTHGATE DR STE 402
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-2632
Mailing Address - Country:US
Mailing Address - Phone:916-883-2244
Mailing Address - Fax:
Practice Address - Street 1:7275 E SOUTHGATE DR STE 402
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2632
Practice Address - Country:US
Practice Address - Phone:916-883-2244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health