Provider Demographics
NPI:1891437133
Name:MARVELLE HOME HEALTH CARE
Entity Type:Organization
Organization Name:MARVELLE HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WALLACE
Authorized Official - Middle Name:KARIUKI
Authorized Official - Last Name:WAHOME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-417-5266
Mailing Address - Street 1:2301 W LINCOLN AVE STE 124B
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-5135
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2301 W LINCOLN AVE STE 124B
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-5135
Practice Address - Country:US
Practice Address - Phone:562-417-5266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-08
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health