MEDICARE: SENSICARE HOME HEALTH INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1154630556
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SENSICARE HOME HEALTH INC

Provider Business Mailing Address
First Line	:	99 N SAN ANTONIO AVE STE 140
Second Line	:
City	:	UPLAND
State	:	CA
Zip	:	91786-4578
Country	:	US
Telephone Number	:	909-949-8833
Fax Number	:	909-949-8834

Provider Business Practice Location Address
First Line	:	99 N SAN ANTONIO AVE STE 140
Second Line	:
City	:	UPLAND
State	:	CA
Zip	:	91786-4578
Country	:	US
Telephone Number	:	909-949-8833
Fax Number	:	909-949-8834

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	NICOLETA UDENZE
Credential	:	RN
Telephone Number	:	909-949-8833

Provider Enumeration Date	:	10/02/2010
Last Update Date	:	03/23/2018

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