Provider Demographics
NPI:1891170270
Name:STANDARD HOMEHEALTH
Entity Type:Organization
Organization Name:STANDARD HOMEHEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:D.O.N.
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARYAM
Authorized Official - Middle Name:
Authorized Official - Last Name:YOHANNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-798-4778
Mailing Address - Street 1:1933 DAVIS STREET
Mailing Address - Street 2:STE 318
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577
Mailing Address - Country:US
Mailing Address - Phone:510-798-4778
Mailing Address - Fax:
Practice Address - Street 1:1933 DAVIS ST
Practice Address - Street 2:STE 318
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-1260
Practice Address - Country:US
Practice Address - Phone:510-798-4778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-27
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550002170251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health