Provider Demographics
NPI:1245975812
Name:MANNA HOME HEALTH INC
Entity type:Organization
Organization Name:MANNA HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:IRYNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MATYUSHENKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-622-0834
Mailing Address - Street 1:2139 TAPO ST STE 207
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-3476
Mailing Address - Country:US
Mailing Address - Phone:056-247-7225
Mailing Address - Fax:
Practice Address - Street 1:2139 TAPO ST STE 207
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-3476
Practice Address - Country:US
Practice Address - Phone:805-624-7225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-28
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health