Provider Demographics
NPI:1720251440
Name:GIBRALTAR HOME HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:GIBRALTAR HOME HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NKEM
Authorized Official - Middle Name:
Authorized Official - Last Name:EZEUKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-880-8600
Mailing Address - Street 1:22141 VENTURA BLVD
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-1663
Mailing Address - Country:US
Mailing Address - Phone:818-880-8600
Mailing Address - Fax:818-880-8675
Practice Address - Street 1:22141 VENTURA BLVD STE 300
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-5734
Practice Address - Country:US
Practice Address - Phone:818-880-8600
Practice Address - Fax:818-880-8675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-03
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health