Provider Demographics
NPI:1609154293
Name:STANDARD HOME HEALTH SERVICES
Entity type:Organization
Organization Name:STANDARD HOME HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EYASU
Authorized Official - Middle Name:
Authorized Official - Last Name:MEKONNEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:310-342-9830
Mailing Address - Street 1:6818 S LA CIENEGA BLVD
Mailing Address - Street 2:SUITE 202A
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90302-7272
Mailing Address - Country:US
Mailing Address - Phone:310-342-9830
Mailing Address - Fax:310-342-9839
Practice Address - Street 1:6818 S LA CIENEGA BLVD
Practice Address - Street 2:SUITE 202A
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90302-7272
Practice Address - Country:US
Practice Address - Phone:310-342-9830
Practice Address - Fax:310-342-9839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-30
Last Update Date:2011-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health