Provider Demographics
NPI:1871284828
Name:MASAGANA HOME CARE SERVICES LLC
Entity type:Organization
Organization Name:MASAGANA HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LENI GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAGASCA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-356-8828
Mailing Address - Street 1:12101 165TH ST
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-7255
Mailing Address - Country:US
Mailing Address - Phone:818-356-8828
Mailing Address - Fax:818-714-8008
Practice Address - Street 1:12101 165TH ST
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-7255
Practice Address - Country:US
Practice Address - Phone:818-356-8828
Practice Address - Fax:818-714-8008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care