Provider Demographics
NPI:1972681195
Name:AGELESS HOME HEALTH CARE
Entity Type:Organization
Organization Name:AGELESS HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CASE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:FENG
Authorized Official - Middle Name:ZHAN
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-921-1554
Mailing Address - Street 1:PO BOX 1365
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-0847
Mailing Address - Country:US
Mailing Address - Phone:650-921-1554
Mailing Address - Fax:800-571-1474
Practice Address - Street 1:10 DE SABLA RD
Practice Address - Street 2:UNIT 1101
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-1273
Practice Address - Country:US
Practice Address - Phone:650-921-1554
Practice Address - Fax:800-571-1474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health