MEDICARE: ALCAM HOME HEALTH CARE 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	:	1326783291
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALCAM HOME HEALTH CARE INC.

Provider Business Mailing Address
First Line	:	1760 CHICAGO AVE STE L21
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92507-2326
Country	:	US
Telephone Number	:	951-782-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1760 CHICAGO AVE STE L21
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92507-2326
Country	:	US
Telephone Number	:	951-782-7000
Fax Number	:

Authorized Official
Title or Position	:	OWNER/MANAGER
Name	:	ALPHA SANUSI
Credential	:
Telephone Number	:	626-622-3359

Provider Enumeration Date	:	05/04/2022
Last Update Date	:	05/04/2022

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