Provider Demographics
NPI:1104151604
Name:COMPANION HOME HEALTH OF THE VALLEY, LLC
Entity type:Organization
Organization Name:COMPANION HOME HEALTH OF THE VALLEY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:FERENCIK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:877-303-0692
Mailing Address - Street 1:12500 RIVERSIDE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91607-3423
Mailing Address - Country:US
Mailing Address - Phone:877-303-0692
Mailing Address - Fax:562-944-2771
Practice Address - Street 1:12500 RIVERSIDE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91607-3423
Practice Address - Country:US
Practice Address - Phone:877-303-0692
Practice Address - Fax:562-944-2771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-16
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health