Provider Demographics
NPI:1063469591
Name:FRIENDLY CARE HOME HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:FRIENDLY CARE HOME HEALTH SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:FOLKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-276-6696
Mailing Address - Street 1:136 W LIME AVE
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91016-2841
Mailing Address - Country:US
Mailing Address - Phone:626-358-3638
Mailing Address - Fax:626-358-3742
Practice Address - Street 1:136 W LIME AVE
Practice Address - Street 2:
Practice Address - City:MONROVIA
Practice Address - State:CA
Practice Address - Zip Code:91016-2841
Practice Address - Country:US
Practice Address - Phone:626-358-3638
Practice Address - Fax:626-358-3742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-29
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980001378251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHHA08126FMedicaid
CAHHA08126FMedicaid