MEDICARE: AMITY HOME HEALTH 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114920931
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMITY HOME HEALTH INC

Provider Business Mailing Address
First Line	:	17042 DEVONSHIRE ST
Second Line	:	STE 220
City	:	NORTHRIDGE
State	:	CA
Zip	:	91325-1679
Country	:	US
Telephone Number	:	818-831-8270
Fax Number	:	818-831-8272

Provider Business Practice Location Address
First Line	:	17042 DEVONSHIRE ST
Second Line	:	STE 220
City	:	NORTHRIDGE
State	:	CA
Zip	:	91325-1679
Country	:	US
Telephone Number	:	818-831-8270
Fax Number	:	818-831-8272

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. EDNA P CABANBAN
Credential	:	RN
Telephone Number	:	818-831-8270

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	08/22/2020

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Directions to “AMITY HOME HEALTH INC ” Practice Location

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