Healthcare Provider Details

I. General information

NPI: 1457656332
Provider Name (Legal Business Name): GREEN MEADOWS HOME HEALTH CARE INC,
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2011
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2204 E 4TH ST STE 200
SANTA ANA CA
92705-3868
US

IV. Provider business mailing address

2204 E 4TH ST STE 200
SANTA ANA CA
92705-3868
US

V. Phone/Fax

Practice location:
  • Phone: 714-838-1055
  • Fax: 714-838-1300
Mailing address:
  • Phone: 714-838-1055
  • Fax: 714-838-1300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number99057885
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number99057885
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number99057885
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number99057885
License Number StateCA

VIII. Authorized Official

Name: DILUVAN SHABBAN HASSAN
Title or Position: CEO
Credential:
Phone: 949-674-5325