Provider Demographics
NPI:1952849663
Name:HAILLE INC
Entity Type:Organization
Organization Name:HAILLE INC
Other - Org Name:365 HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDIKARIM
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSSEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:349-307-5382
Mailing Address - Street 1:7484 UNIVERSITY AVE
Mailing Address - Street 2:SUITE 330
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-6063
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7484 UNIVERSITY AVE
Practice Address - Street 2:SUITE 330
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-6063
Practice Address - Country:US
Practice Address - Phone:619-741-5382
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-02
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care