Provider Demographics
NPI:1295990034
Name:FLORENCE HOME HEALTH CARE
Entity type:Organization
Organization Name:FLORENCE HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:REZA
Authorized Official - Middle Name:
Authorized Official - Last Name:FARAHANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-497-1674
Mailing Address - Street 1:2521 E THOUSAND OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91362-3259
Mailing Address - Country:US
Mailing Address - Phone:805-497-1674
Mailing Address - Fax:
Practice Address - Street 1:2521 E THOUSAND OAKS BLVD
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91362-3259
Practice Address - Country:US
Practice Address - Phone:805-497-1674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-21
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA059243Medicare PIN