Provider Demographics
NPI:1912989005
Name:OBOE HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:OBOE HEALTH SERVICES, INC
Other - Org Name:METROPOLITAN HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NORA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSUEGO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:818-508-5801
Mailing Address - Street 1:12135 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-3832
Mailing Address - Country:US
Mailing Address - Phone:818-508-5801
Mailing Address - Fax:818-508-5821
Practice Address - Street 1:12135 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:VALLEY VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91607-3832
Practice Address - Country:US
Practice Address - Phone:818-508-5801
Practice Address - Fax:818-508-5821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-15
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980001348251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHHA08090FMedicaid
CAHHA08090FMedicaid