Provider Demographics
NPI:1932478187
Name:AVID HOME CARE
Entity Type:Organization
Organization Name:AVID HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERIFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-295-5168
Mailing Address - Street 1:5838 OVERHILL DR.2A
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90043
Mailing Address - Country:US
Mailing Address - Phone:323-295-5168
Mailing Address - Fax:323-295-5158
Practice Address - Street 1:5838 OVERHILL DR STE 2A
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90043-2738
Practice Address - Country:US
Practice Address - Phone:323-295-5168
Practice Address - Fax:323-295-5158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-16
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care