Profound Health Care

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PROFOUND HEALTH CARE

Practice address

4078 Crenshaw Blvd
Los Angeles, CA 90008-2515

Phone

(323) 294-3559

Fax

(323) 294-3362

NPI assigned

Dec 4, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Bennie Nibo

Title

Administrator

Phone

(323) 294-3559

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497813349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4078 CRENSHAW BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900082515",
            "telephone_number": "323-294-3559",
            "fax_number": "323-294-3362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4078 CRENSHAW BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900082515",
            "telephone_number": "323-294-3559",
            "fax_number": "323-294-3362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFOUND HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NIBO",
        "authorized_official_first_name": "BENNIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "323-294-3559"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HHA08024F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Professional Physicians Inc
• Profhealth Westlake Group
• Rosalind Michelle Profit
• Profizix Physical Therapy and Wellness P.C.
• Proformance Physical Therapy and Rehabilitation, Inc. (PRO Physical Therapy)
• Profound Treatment
• Profound Treatment, LLC (West Health)
• Program for Torture Victims
• Progressive 2000 Home Health Care Inc
• Progressive Clinical Services, LLC

• Home Health Agency in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.