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General NPI Number Information
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NPI Number | 1144474446
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Entity Type | Organization
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Legal Business Name | LAX HOME HEALTH SERVICES
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Dates
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Enumeration Date | 11/13/2008
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Last Update Date | 11/13/2008
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Provider Practice Location Address
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Address Line | 8109 2ND ST STE 3
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City | DOWNEY
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State | CA
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Zip | 90241-3623
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Country | US
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Telephone | 562-923-3990
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Fax | 562-923-2440
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Provider Business Mailing Address
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Address Line | 8109 2ND STREET SUITE#3
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City | DOWNEY
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State | CA
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Zip | 90241
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Country | US
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Telephone | 562-923-3990
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR, CEO
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Name | MRS. MYRIAN MELNECHUK
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Credential | OT
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Telephone | 562-923-3990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 980000736
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License Number State | CA
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