Provider Demographics
NPI:1861451841
Name:GIDDA'S HOME HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:GIDDA'S HOME HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:ISATU
Authorized Official - Middle Name:NENEH
Authorized Official - Last Name:TIMBO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:310-644-0985
Mailing Address - Street 1:13351 HAWTHORNE BLVD
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-5802
Mailing Address - Country:US
Mailing Address - Phone:310-644-0985
Mailing Address - Fax:310-644-5566
Practice Address - Street 1:13351 HAWTHORNE BLVD
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-5802
Practice Address - Country:US
Practice Address - Phone:310-644-0985
Practice Address - Fax:310-644-5566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-20
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980001490251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA058226Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER