Provider Demographics
NPI:1841242161
Name:HOME HEALTH SERVICES OF CALIFORNIA, INC.
Entity Type:Organization
Organization Name:HOME HEALTH SERVICES OF CALIFORNIA, INC.
Other - Org Name:HOME HEALTH CALIFORNIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:AYOUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:HAHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-385-9949
Mailing Address - Street 1:611 S CATALINA ST STE 318
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90005-1703
Mailing Address - Country:US
Mailing Address - Phone:213-385-9949
Mailing Address - Fax:213-385-9950
Practice Address - Street 1:611 S CATALINA ST STE 318
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90005-1703
Practice Address - Country:US
Practice Address - Phone:213-385-9949
Practice Address - Fax:213-385-9950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980001312251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHHA058056FMedicaid
CA058056Medicare ID - Type UnspecifiedHOME HEALTH AGENCY