Provider Demographics
NPI:1700958261
Name:SHEPHERD HOME HEALTH CARE INC
Entity type:Organization
Organization Name:SHEPHERD HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PERSIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ODETTE
Authorized Official - Middle Name:R
Authorized Official - Last Name:NAYROUZ
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:323-932-8851
Mailing Address - Street 1:5455 WILSHIRE BLVD STE 705
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-4234
Mailing Address - Country:US
Mailing Address - Phone:323-932-8851
Mailing Address - Fax:323-932-8983
Practice Address - Street 1:5455 WILSHIRE BLVD STE 705
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-4234
Practice Address - Country:US
Practice Address - Phone:323-932-8851
Practice Address - Fax:323-932-8983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26773218251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health