Provider Demographics
NPI:1013105238
Name:CARELINE HEALTHCARE, INC.
Entity Type:Organization
Organization Name:CARELINE HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RASKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-786-4808
Mailing Address - Street 1:14540 VICTORY BLVD
Mailing Address - Street 2:#232
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-1600
Mailing Address - Country:US
Mailing Address - Phone:818-786-4808
Mailing Address - Fax:818-786-4989
Practice Address - Street 1:14540 VICTORY BLVD
Practice Address - Street 2:#232
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-1600
Practice Address - Country:US
Practice Address - Phone:818-786-4808
Practice Address - Fax:818-786-4989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-12
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550000300251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health