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General NPI Number Information
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NPI Number | 1346523784
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Entity Type | Organization
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Legal Business Name | OLIVE HOME HEALTH CENTER INC
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Dates
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Enumeration Date | 09/22/2011
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Last Update Date | 03/04/2013
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Provider Practice Location Address
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Address Line | 2222 W MANCHESTER BLVD SUITE B
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City | INGLEWOOD
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State | CA
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Zip | 90305-2524
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Country | US
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Telephone | 323-751-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 2222 W MANCHESTER BLVD SUITE B
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City | INGLEWOOD
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State | CA
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Zip | 90305-2529
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Country | US
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Telephone | 323-751-7000
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | EKATTE ITON
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Credential |
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Telephone | 323-751-7000
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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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