MEDICARE: SANTA MARIA 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

General Provider Information

NPI Number	:	1760110613
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANTA MARIA HOME HEALTH INC

Provider Business Mailing Address
First Line	:	9608 VAN NUYS BLVD STE 105
Second Line	:
City	:	PANORAMA CITY
State	:	CA
Zip	:	91402-1042
Country	:	US
Telephone Number	:	818-851-6451
Fax Number	:	818-851-6452

Provider Business Practice Location Address
First Line	:	9608 VAN NUYS BLVD STE 105
Second Line	:
City	:	PANORAMA CITY
State	:	CA
Zip	:	91402-1042
Country	:	US
Telephone Number	:	818-851-6451
Fax Number	:	818-851-6452

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. IRINA RASKOPIN
Credential	:
Telephone Number	:	818-851-6451

Provider Enumeration Date	:	08/09/2022
Last Update Date	:	04/02/2024

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Directions to “SANTA MARIA HOME HEALTH INC ” Practice Location

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