Provider Demographics
NPI:1114924057
Name:METRO HOME CARE, INC.
Entity type:Organization
Organization Name:METRO HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:VIC
Authorized Official - Middle Name:
Authorized Official - Last Name:SOGHOMONIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-709-2277
Mailing Address - Street 1:16800 DEVONSHIRE ST.
Mailing Address - Street 2:STE 205
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-7409
Mailing Address - Country:US
Mailing Address - Phone:818-709-2277
Mailing Address - Fax:818-709-2272
Practice Address - Street 1:18531 ROSCOE BLVD
Practice Address - Street 2:#214
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-5444
Practice Address - Country:US
Practice Address - Phone:818-709-2277
Practice Address - Fax:818-709-2272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980000965251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHHA-57618FMedicaid
55-7618Medicare ID - Type Unspecified