Provider Demographics
NPI:1972611846
Name:LIVINGSTONE HOME HEALTH SERVICES INC.
Entity Type:Organization
Organization Name:LIVINGSTONE HOME HEALTH SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KI SOOK
Authorized Official - Middle Name:
Authorized Official - Last Name:LYN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:714-994-6329
Mailing Address - Street 1:6301 BEACH BLVD
Mailing Address - Street 2:SUITE 212
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-2840
Mailing Address - Country:US
Mailing Address - Phone:714-994-6329
Mailing Address - Fax:714-994-6374
Practice Address - Street 1:6301 BEACH BLVD
Practice Address - Street 2:SUITE 212
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-2840
Practice Address - Country:US
Practice Address - Phone:714-994-6329
Practice Address - Fax:714-994-6374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA8730762251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHHA07422GMedicaid
CA057422Medicare ID - Type Unspecified