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General NPI Number Information
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NPI Number | 1295037992
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Entity Type | Organization
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Legal Business Name | ETERNITY HOME HEALTH, INC.
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Dates
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Enumeration Date | 12/01/2010
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Last Update Date | 12/01/2010
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Provider Practice Location Address
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Address Line | 15859 EDNA PLACE SUITE 111
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City | IRWINDALE
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State | CA
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Zip | 91706-2153
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Country | US
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Telephone | 626-337-8699
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Fax | 626-337-8689
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Provider Business Mailing Address
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Address Line | 15859 EDNA PLACE SUITE 111
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City | IRWINDALE
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State | CA
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Zip | 91706-2153
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Country | US
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Telephone | 626-337-8699
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Fax | 626-337-8689
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. ALEX CHERNOBELSKY
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Credential |
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Telephone | 626-337-8699
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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 |
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License Number State |
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