Provider Demographics
NPI:1972362903
Name:OMOIYARI, INC.
Entity Type:Organization
Organization Name:OMOIYARI, INC.
Other - Org Name:FIRSTLIGHT HOME CARE OF SIMI VALLEY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOT
Authorized Official - Middle Name:
Authorized Official - Last Name:KURATSU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-660-0321
Mailing Address - Street 1:1749 HEYWOOD ST
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-3425
Mailing Address - Country:US
Mailing Address - Phone:805-660-0117
Mailing Address - Fax:805-874-5220
Practice Address - Street 1:2655 1ST ST STE 250
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-1574
Practice Address - Country:US
Practice Address - Phone:805-915-4706
Practice Address - Fax:805-874-5220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-13
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care