Organization
AMBASSADOR HOME HEALTH, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS GIFTY ANNETTE DUBOIS RN (ADMINISTRATOR, CEO)
(562) 923-3990
Entity
Organization
Contact information
Practice address
8109 2ND ST, SUITE #3, DOWNEY, CA 90241-3623
(562) 923-3990
(562) 923-2440
Mailing address
8109 2ND ST, SUITE #3, DOWNEY, CA 90241-3623
(562) 923-3990
(562) 923-2440
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HHA07428F
—
CA
01
—
ZZZ24141Z
BLUE SHIELD PROVIDER NUMB
CA
Enumeration date
12/01/2005
Last updated
08/22/2020
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