=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043495534
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EASTERN HOME HEALTH, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/03/2008
-----------------------------------------------------
Last Update Date | 02/18/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2463 TORRANCE BLVD SUITES C AND D
-----------------------------------------------------
City | TORRANCE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90501-2498
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-328-2980
-----------------------------------------------------
Fax | 310-328-2985
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2463 WEST TORRANCE BLVD SUITES C & D
-----------------------------------------------------
City | TORRANCE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90501
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-328-2980
-----------------------------------------------------
Fax | 310-328-2985
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MS. EVELYN RAMOS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 310-816-2980
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 980001559
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------