Healthcare Provider Details

I. General information

NPI: 1982074167
Provider Name (Legal Business Name): CARE MATTERS HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2015
Last Update Date: 05/19/2023
Certification Date: 05/19/2023
Deactivation Date: 09/18/2019
Reactivation Date: 09/26/2019

III. Provider practice location address

5055 EXPOSITION BLVD
LOS ANGELES CA
90016-3913
US

IV. Provider business mailing address

5055 EXPOSITION BLVD
LOS ANGELES CA
90016-3913
US

V. Phone/Fax

Practice location:
  • Phone: 310-912-9274
  • Fax: 424-789-8118
Mailing address:
  • Phone: 310-912-9274
  • Fax: 424-789-8118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: CHANNON M MITCHELL
Title or Position: CEO/ADMINISTRATOR
Credential:
Phone: 310-912-9274