Healthcare Provider Details

I. General information

NPI: 1679063911
Provider Name (Legal Business Name): MEDICUS HOME HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2018
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8904 RESEDA BLVD STE 204
NORTHRIDGE CA
91324-3930
US

IV. Provider business mailing address

8904 RESEDA BLVD STE 204
NORTHRIDGE CA
91324-3930
US

V. Phone/Fax

Practice location:
  • Phone: 818-280-6350
  • Fax: 818-280-6351
Mailing address:
  • Phone: 818-280-6350
  • Fax: 818-280-6351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: LEIGH MILTIMORE
Title or Position: REGIONAL ADMINISTRATOR
Credential:
Phone: 502-257-9869