Provider Demographics
NPI:1811165228
Name:MEDFORT HOME HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:MEDFORT HOME HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:YOUBERT
Authorized Official - Middle Name:D
Authorized Official - Last Name:TABOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-541-1221
Mailing Address - Street 1:2331 HONOLULU AVE
Mailing Address - Street 2:SUITE H
Mailing Address - City:MONTROSE
Mailing Address - State:CA
Mailing Address - Zip Code:91020-1856
Mailing Address - Country:US
Mailing Address - Phone:818-541-1221
Mailing Address - Fax:818-242-3700
Practice Address - Street 1:2331 HONOLULU AVE
Practice Address - Street 2:SUITE H
Practice Address - City:MONTROSE
Practice Address - State:CA
Practice Address - Zip Code:91020-1856
Practice Address - Country:US
Practice Address - Phone:818-541-1221
Practice Address - Fax:818-242-3700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health