Provider Demographics
NPI:1942494281
Name:MHIRAMARC MANAGEMENT LLC HOME HEALTH SERVICES
Entity Type:Organization
Organization Name:MHIRAMARC MANAGEMENT LLC HOME HEALTH SERVICES
Other - Org Name:MHIRAMARC MANAGEMENT LLC HOME HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FERNAND
Authorized Official - Middle Name:BAMBA
Authorized Official - Last Name:TARUC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-352-9561
Mailing Address - Street 1:7473 FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:TUJUNGA
Mailing Address - State:CA
Mailing Address - Zip Code:91042-2726
Mailing Address - Country:US
Mailing Address - Phone:818-352-9561
Mailing Address - Fax:818-352-9559
Practice Address - Street 1:7473 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:TUJUNGA
Practice Address - State:CA
Practice Address - Zip Code:91042-2726
Practice Address - Country:US
Practice Address - Phone:818-352-9561
Practice Address - Fax:818-352-9559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550001086251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA059325Medicare Oscar/Certification