MEDICARE: GRISWOLD HOME CARE FOR GREATER THOUSAND OAKS

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1376476564
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRISWOLD HOME CARE FOR GREATER THOUSAND OAKS

Provider Business Mailing Address
First Line	:	3625 E THOUSAND OAKS BLVD STE 116
Second Line	:
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91362-3553
Country	:	US
Telephone Number	:	805-852-0911
Fax Number	:	805-852-0911

Provider Business Practice Location Address
First Line	:	3625 E THOUSAND OAKS BLVD STE 116
Second Line	:
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91362-3553
Country	:	US
Telephone Number	:	805-852-0911
Fax Number	:	805-852-0911

Authorized Official
Title or Position	:	DIRECTOR
Name	:	GRANT MEIKLE
Credential	:
Telephone Number	:	805-852-0911

Provider Enumeration Date	:	06/05/2026
Last Update Date	:	06/05/2026

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