Provider Demographics
NPI:1356807820
Name:ORIGINS HOME HEALTHCARE PLUS INC
Entity type:Organization
Organization Name:ORIGINS HOME HEALTHCARE PLUS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JUANITA SHIRLEY
Authorized Official - Middle Name:VILLEGAS
Authorized Official - Last Name:TANUYAN
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:657-371-5018
Mailing Address - Street 1:PO BOX 224
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-0224
Mailing Address - Country:US
Mailing Address - Phone:657-371-5018
Mailing Address - Fax:657-202-1088
Practice Address - Street 1:137 1/2 S KNOTT AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-1406
Practice Address - Country:US
Practice Address - Phone:657-371-5018
Practice Address - Fax:657-202-1088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-20
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health