MEDICARE: CENTURY 21ST HEALTH SERVICES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency		CA

General Provider Information

NPI Number	:	1063796803
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTURY 21ST HEALTH SERVICES, INC

Provider Business Mailing Address
First Line	:	8621 BELLANCA AVE STE 102
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-4418
Country	:	US
Telephone Number	:	310-866-7396
Fax Number	:	310-997-0973

Provider Business Practice Location Address
First Line	:	8621 BELLANCA AVE STE 102
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-4418
Country	:	US
Telephone Number	:	310-866-7396
Fax Number	:	310-997-0973

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. LUBA LEA DROZ
Credential	:	RN, MSM
Telephone Number	:	310-866-7396

Provider Enumeration Date	:	09/28/2011
Last Update Date	:	09/28/2011

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