=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497273940
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AMBER CARE HOME HEALTH, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/05/2017
-----------------------------------------------------
Last Update Date | 07/21/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8949 RESEDA BLVD STE 111
-----------------------------------------------------
City | NORTHRIDGE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91324-5801
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-207-2976
-----------------------------------------------------
Fax | 818-810-0251
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8949 RESEDA BLVD STE 111
-----------------------------------------------------
City | NORTHRIDGE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91324-5801
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-497-4654
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | QA
-----------------------------------------------------
Name | REBECCA MARTORELLA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 818-207-2976
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------