Healthcare Provider Details

I. General information

NPI: 1114920931
Provider Name (Legal Business Name): AMITY HOME HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17042 DEVONSHIRE ST STE 220
NORTHRIDGE CA
91325-1679
US

IV. Provider business mailing address

17042 DEVONSHIRE ST STE 220
NORTHRIDGE CA
91325-1679
US

V. Phone/Fax

Practice location:
  • Phone: 818-831-8270
  • Fax: 818-831-8272
Mailing address:
  • Phone: 818-831-8270
  • Fax: 818-831-8272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateCA

VIII. Authorized Official

Name: MRS. EDNA P CABANBAN
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 818-831-8270