MEDICARE: ATTENDICARE, LLC

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1558821298
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATTENDICARE, LLC

Provider Business Mailing Address
First Line	:	39899 BALENTINE DR STE 200
Second Line	:
City	:	NEWARK
State	:	CA
Zip	:	94560-5361
Country	:	US
Telephone Number	:	510-987-8889
Fax Number	:

Provider Business Practice Location Address
First Line	:	39899 BALENTINE DR STE 200
Second Line	:
City	:	NEWARK
State	:	CA
Zip	:	94560-5361
Country	:	US
Telephone Number	:	510-987-8889
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	PETER WANG
Credential	:
Telephone Number	:	510-987-8889

Provider Enumeration Date	:	03/20/2019
Last Update Date	:	03/20/2019

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