Provider Demographics
NPI:1194812255
Name:UNISON HEALTH SERVICES INC
Entity type:Organization
Organization Name:UNISON HEALTH SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARPENTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-280-5575
Mailing Address - Street 1:2200 S FREMONT AVE UNIT 202
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-4316
Mailing Address - Country:US
Mailing Address - Phone:626-280-5575
Mailing Address - Fax:626-307-5575
Practice Address - Street 1:2200 S FREMONT AVE UNIT 202
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91803-4316
Practice Address - Country:US
Practice Address - Phone:626-280-5575
Practice Address - Fax:626-307-5575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980001441251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHHA08165FMedicaid
CA058165Medicare ID - Type Unspecified