MEDICARE: SANTA CLARITA 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	980001015	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	:	1346249869
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANTA CLARITA HOME HEALTH INC.

Provider Business Mailing Address
First Line	:	22620 MARKET ST
Second Line	:	SUITE 200
City	:	SANTA CLARITA
State	:	CA
Zip	:	91321-3104
Country	:	US
Telephone Number	:	661-222-7889
Fax Number	:	661-222-7454

Provider Business Practice Location Address
First Line	:	23655 NEWHALL AVE
Second Line	:	SUITE A
City	:	SANTA CLARITA
State	:	CA
Zip	:	91321-3104
Country	:	US
Telephone Number	:	661-222-7889
Fax Number	:	661-222-7454

Authorized Official
Title or Position	:	CEO/ADMINISTRATOR
Name	:	MR. PAUL M DEREK
Credential	:
Telephone Number	:	661-222-7889

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	05/23/2018

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