Healthcare Provider Details

I. General information

NPI: 1073377123
Provider Name (Legal Business Name): WELCOME HOME ATASCADERO, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2024
Last Update Date: 02/09/2024
Certification Date: 02/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14900 EL CAMINO REAL
ATASCADERO CA
93422-6417
US

IV. Provider business mailing address

1780 PEACH PL
CONCORD CA
94518-3155
US

V. Phone/Fax

Practice location:
  • Phone: 341-999-3911
  • Fax:
Mailing address:
  • Phone: 341-999-3911
  • Fax: 888-909-8858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number
License Number State

VIII. Authorized Official

Name: STEVE CHOU
Title or Position: CEO
Credential:
Phone: 341-999-3911