Provider Demographics
NPI:1871141937
Name:SKILLED HOME HEALTH, INC.
Entity type:Organization
Organization Name:SKILLED HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:MOISES
Authorized Official - Middle Name:
Authorized Official - Last Name:BERCOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-244-1360
Mailing Address - Street 1:8221 3RD ST STE 201
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-3735
Mailing Address - Country:US
Mailing Address - Phone:562-450-1690
Mailing Address - Fax:
Practice Address - Street 1:8202 FLORENCE AVE STE 203
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-3937
Practice Address - Country:US
Practice Address - Phone:562-450-1690
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-30
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health