Provider Demographics
NPI:1154900447
Name:EZZY HOMECARE AND STAFFING AGENCY LLC
Entity type:Organization
Organization Name:EZZY HOMECARE AND STAFFING AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:CHIJOJE
Authorized Official - Last Name:UDENGWU
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:562-450-9455
Mailing Address - Street 1:13658 HAWTHORNE BLVD STE 402
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-5824
Mailing Address - Country:US
Mailing Address - Phone:562-450-9455
Mailing Address - Fax:
Practice Address - Street 1:13658 HAWTHORNE BLVD STE 402
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-5824
Practice Address - Country:US
Practice Address - Phone:562-450-9455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-05
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care