Provider Demographics
NPI:1891759163
Name:CITYWIDE HOME CARE INC.
Entity Type:Organization
Organization Name:CITYWIDE HOME CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:CHING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-502-9151
Mailing Address - Street 1:301 E GLENOAKS BLVD
Mailing Address - Street 2:UNIT 4
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91207-2075
Mailing Address - Country:US
Mailing Address - Phone:818-502-9151
Mailing Address - Fax:818-502-9352
Practice Address - Street 1:301 E GLENOAKS BLVD
Practice Address - Street 2:UNIT 4
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91207-2075
Practice Address - Country:US
Practice Address - Phone:818-502-9151
Practice Address - Fax:818-502-9352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-13
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980001485251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA058266Medicare ID - Type UnspecifiedPROVIDER NUMBER