MEDICARE: LIAHONA 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

General Provider Information

NPI Number	:	1780338731
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIAHONA HOME HEALTH SERVICES, INC.

Provider Business Mailing Address
First Line	:	155 N RIVERVIEW DR UNIT 121
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92808-1225
Country	:	US
Telephone Number	:	714-769-9033
Fax Number	:

Provider Business Practice Location Address
First Line	:	155 N RIVERVIEW DR UNIT 121
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92808-1225
Country	:	US
Telephone Number	:	714-769-9033
Fax Number	:

Authorized Official
Title or Position	:	CEO ADMINISTRATOR
Name	:	MS. ELLEN TAPIA
Credential	:
Telephone Number	:	812-251-8812

Provider Enumeration Date	:	02/08/2022
Last Update Date	:	08/16/2023

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