Provider Demographics
NPI:1194959346
Name:INNERJOY HOME HEALTH SERVICES
Entity type:Organization
Organization Name:INNERJOY HOME HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:MICHAYLUK
Authorized Official - Suffix:
Authorized Official - Credentials:DBA
Authorized Official - Phone:805-522-1420
Mailing Address - Street 1:1965 YOSEMITE AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-5220
Mailing Address - Country:US
Mailing Address - Phone:805-522-1420
Mailing Address - Fax:805-522-1704
Practice Address - Street 1:1965 YOSEMITE AVE STE 120
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-5220
Practice Address - Country:US
Practice Address - Phone:805-522-1420
Practice Address - Fax:805-522-1704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-02
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA059252Medicare Oscar/Certification