MEDICARE: CAPRI HOME HEALTH AGENCY, 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	DHS 000002256	CA

General Provider Information

NPI Number	:	1710996798
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAPRI HOME HEALTH AGENCY, INC.

Provider Business Mailing Address
First Line	:	18800 AMAR RD
Second Line	:	SUITE C-13
City	:	WALNUT
State	:	CA
Zip	:	91789-4166
Country	:	US
Telephone Number	:	626-810-0207
Fax Number	:	626-810-0250

Provider Business Practice Location Address
First Line	:	18800 AMAR RD
Second Line	:	SUITE C-13
City	:	WALNUT
State	:	CA
Zip	:	91789-4166
Country	:	US
Telephone Number	:	626-810-0207
Fax Number	:	626-810-0250

Authorized Official
Title or Position	:	OFFICER
Name	:	EVELYN KATIGBAK
Credential	:
Telephone Number	:	626-810-0207

Provider Enumeration Date	:	08/07/2006
Last Update Date	:	07/01/2008

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