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General NPI Number Information
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NPI Number | 1255310900
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Entity Type | Organization
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Legal Business Name | HOME HEALTH INTEGRATED SERVICES, INC
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Dates
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Enumeration Date | 01/11/2006
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Last Update Date | 11/02/2023
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Provider Practice Location Address
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Address Line | 704 S MAIN ST
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City | BURBANK
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State | CA
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Zip | 91506-2529
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Country | US
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Telephone | 818-558-6685
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Fax | 818-558-6718
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Provider Business Mailing Address
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Address Line | 704 S MAIN ST
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City | BURBANK
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State | CA
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Zip | 91506-2529
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Country | US
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Telephone | 818-558-6685
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Fax | 818-558-6718
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Authorized Official
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Title or Position | PRESIDENT /CEO
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Name | MR. AEGEAN JAIME CAROLINO
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Credential |
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Telephone | 818-558-6685
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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 | 980000859
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License Number State | CA
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