Provider Demographics
NPI:1255458170
Name:VALLEY HOME HEALTH CARE AGENCY, INC.
Entity type:Organization
Organization Name:VALLEY HOME HEALTH CARE AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NYDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:STA MARIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-300-0223
Mailing Address - Street 1:5530 CORBIN AVE
Mailing Address - Street 2:SUITE 112
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-2914
Mailing Address - Country:US
Mailing Address - Phone:818-300-0223
Mailing Address - Fax:818-300-0227
Practice Address - Street 1:5530 CORBIN AVE
Practice Address - Street 2:SUITE 112
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2914
Practice Address - Country:US
Practice Address - Phone:818-300-0223
Practice Address - Fax:818-300-0227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-24
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550000733251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA059049Medicare Oscar/Certification