1508064130 NPI number — AMERICADE HOME HEALTH AGENCY LLC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508064130 NPI number — AMERICADE HOME HEALTH AGENCY LLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMERICADE HOME HEALTH AGENCY LLC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1508064130
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9040 TELSTAR AVE STE 127
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EL MONTE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91731-2839
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
323-278-1283
Provider Business Mailing Address Fax Number:
323-728-4263

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
111 W BEVERLY BLVD STE 224
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONTEBELLO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90640-4320
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-278-1283
Provider Business Practice Location Address Fax Number:
323-728-4263
Provider Enumeration Date:
07/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
RAMIREZ
Authorized Official First Name:
MARY
Authorized Official Middle Name:
L
Authorized Official Title or Position:
DON
Authorized Official Telephone Number:
323-278-1283

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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