Provider Demographics
NPI:1104640689
Name:YOUR CHOICE HOME HEALTH CARE AGENCY
Entity type:Organization
Organization Name:YOUR CHOICE HOME HEALTH CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:BALAROSAN
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:310-634-4508
Mailing Address - Street 1:3185 WILSHIRE BLVD UNIT 783
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-1253
Mailing Address - Country:US
Mailing Address - Phone:310-634-4508
Mailing Address - Fax:
Practice Address - Street 1:9730 WILSHIRE BLVD STE 207
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-2004
Practice Address - Country:US
Practice Address - Phone:310-634-4508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion