Provider Demographics
NPI:1831836626
Name:AMETHYST HOME CARE INC.
Entity type:Organization
Organization Name:AMETHYST HOME CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDURASHIDOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-294-6298
Mailing Address - Street 1:2139 TAPO ST STE 207A
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-3476
Mailing Address - Country:US
Mailing Address - Phone:805-842-9721
Mailing Address - Fax:805-842-9722
Practice Address - Street 1:2139 TAPO ST STE 207A
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-3476
Practice Address - Country:US
Practice Address - Phone:805-842-9721
Practice Address - Fax:805-842-9722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-13
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health