MEDICARE: MC HOME 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	:	1528040284
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MC HOME HEALTH SERVICES, INC

Provider Business Mailing Address
First Line	:	18800 AMAR RD
Second Line	:	SUITE B-5
City	:	WALNUT
State	:	CA
Zip	:	91789-4166
Country	:	US
Telephone Number	:	626-854-1450
Fax Number	:	626-854-1451

Provider Business Practice Location Address
First Line	:	18800 AMAR RD
Second Line	:	SUITE B-5
City	:	WALNUT
State	:	CA
Zip	:	91789-4166
Country	:	US
Telephone Number	:	626-854-1450
Fax Number	:	626-854-1451

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. MARILYN BALAUAG CABICO
Credential	:	RN
Telephone Number	:	626-854-1450

Provider Enumeration Date	:	11/17/2005
Last Update Date	:	07/10/2007

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