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Organization
PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA
Active
Organization
PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA
Active
Other names
Providence Home Care, PROVIDENCE HOME HEALTH LA COUNTY NORTH
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD W ANDERSON JR. (ASSISTANT SECRETARY FOR ENROLLMENT)
(425) 358-9786
Entity
Organization
Contact information
Practice address
250 E OLIVE AVE STE 202, BURBANK, CA 91502-1211
(818) 953-4451
(747) 229-2365
Mailing address
250 E OLIVE AVE STE 202, BURBANK, CA 91502-1211
(818) 953-4451
(747) 229-2365
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
980000499
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HHA07627F
—
CA
Enumeration date
06/30/2005
Last updated
05/16/2025
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