Organization
LAX HOME HEALTH SERVICES
Active
Other names
DBA: ALPHA GENESIS HOME HEALTH
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MYRIAN MELNECHUK OT (ADMINISTRATOR, CEO)
(562) 923-3990
Entity
Organization
Contact information
Practice address
8109 2ND ST STE 3, DOWNEY, CA 90241-3623
(562) 923-3990
(562) 923-2440
Mailing address
8109 2ND STREET SUITE#3, DOWNEY, CA 90241
(562) 923-3990
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
980000736
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HHA07428G
—
CA
01
—
ZZZ24141Z
BLUE SHIELD PROVIDER NUMBER
—
Enumeration date
11/13/2008
Last updated
11/13/2008
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