Provider Demographics
NPI:1952675233
Name:UNIVERSAL PREVENTIVE HOME HEALTH CARE, INC
Entity Type:Organization
Organization Name:UNIVERSAL PREVENTIVE HOME HEALTH CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIELIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-526-8800
Mailing Address - Street 1:2139 TAPO ST
Mailing Address - Street 2:# 205
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-3478
Mailing Address - Country:US
Mailing Address - Phone:805-526-8800
Mailing Address - Fax:805-526-8802
Practice Address - Street 1:2139 TAPO ST
Practice Address - Street 2:# 205
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-3478
Practice Address - Country:US
Practice Address - Phone:805-526-8800
Practice Address - Fax:805-526-8802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-03
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA059522Medicare Oscar/Certification