Healthcare Provider Details

I. General information

NPI: 1588407423
Provider Name (Legal Business Name): KARELIA HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2024
Last Update Date: 06/18/2024
Certification Date: 06/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16959 BERNARDO CENTER DR STE 210
SAN DIEGO CA
92128-2555
US

IV. Provider business mailing address

16959 BERNARDO CENTER DR STE 210
SAN DIEGO CA
92128-2555
US

V. Phone/Fax

Practice location:
  • Phone: 858-832-9007
  • Fax:
Mailing address:
  • Phone: 858-832-9007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: KARELIA MA
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 858-832-9007