Provider Demographics
NPI:1184151136
Name:AVID HOME HEALTH INC
Entity type:Organization
Organization Name:AVID HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JOY MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOISES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-391-9006
Mailing Address - Street 1:25527 SINCLAIR PL
Mailing Address - Street 2:
Mailing Address - City:STEVENSON RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91381-1411
Mailing Address - Country:US
Mailing Address - Phone:818-468-5513
Mailing Address - Fax:267-937-6246
Practice Address - Street 1:609 N LEMON ST STE 11
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91764-3760
Practice Address - Country:US
Practice Address - Phone:909-391-9006
Practice Address - Fax:267-937-6246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-20
Last Update Date:2017-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health