Healthcare Provider Details

I. General information

NPI: 1427298736
Provider Name (Legal Business Name): HIGH DESERT HOME CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2009
Last Update Date: 02/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19822 HAIDA ROAD
APPLE VALLEY CA
92307-5572
US

IV. Provider business mailing address

HOMEWATCH CAREGIVERS 20160 HWY. 18 STE. G PMB # 198
APPLE VALLEY CA
92307-2935
US

V. Phone/Fax

Practice location:
  • Phone: 760-810-7161
  • Fax: 760-810-7162
Mailing address:
  • Phone: 760-810-7161
  • Fax: 760-810-7162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number00009739
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number00009739
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number00009739
License Number StateCA

VIII. Authorized Official

Name: MRS. SHARON BETH ABREU
Title or Position: OFFICE MANAGER
Credential:
Phone: 760-810-7161