Provider Demographics
NPI:1669922183
Name:A PRIME HOME HEALTH SERVICES, INC
Entity type:Organization
Organization Name:A PRIME HOME HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:CADDUCIUS
Authorized Official - Last Name:VILLALUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-332-6755
Mailing Address - Street 1:266 MOBIL AVE STE 215
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-6336
Mailing Address - Country:US
Mailing Address - Phone:877-332-6755
Mailing Address - Fax:805-322-7055
Practice Address - Street 1:266 MOBIL AVE STE 215
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-6336
Practice Address - Country:US
Practice Address - Phone:877-332-6755
Practice Address - Fax:805-322-7055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-07
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health