Provider Demographics
NPI:1538771837
Name:WESTERN HOME HEALTH INC
Entity type:Organization
Organization Name:WESTERN HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NICOLAS IV
Authorized Official - Middle Name:DE LEON
Authorized Official - Last Name:DIO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:747-231-1345
Mailing Address - Street 1:2626 FOOTHILL BLVD.
Mailing Address - Street 2:STE. 210
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-3574
Mailing Address - Country:US
Mailing Address - Phone:747-231-1345
Mailing Address - Fax:818-396-3145
Practice Address - Street 1:2626 FOOTHILL BLVD.
Practice Address - Street 2:STE. 210
Practice Address - City:LA CRESCENTA
Practice Address - State:CA
Practice Address - Zip Code:91214-3574
Practice Address - Country:US
Practice Address - Phone:747-231-1345
Practice Address - Fax:818-396-3145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-18
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health