Provider Demographics
NPI:1922006030
Name:HEALING HANDS HOME HEALTHCARE, INC.
Entity type:Organization
Organization Name:HEALING HANDS HOME HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESITA
Authorized Official - Middle Name:ADLAWAN
Authorized Official - Last Name:PREJILLANA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:323-739-0333
Mailing Address - Street 1:2525 COLORADO BLVD.
Mailing Address - Street 2:SUITE D
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-1602
Mailing Address - Country:US
Mailing Address - Phone:323-739-0333
Mailing Address - Fax:323-739-0330
Practice Address - Street 1:2525 COLORADO BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90041-1062
Practice Address - Country:US
Practice Address - Phone:323-739-0333
Practice Address - Fax:323-739-0330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980001349251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA058084Medicare Oscar/Certification