Healthcare Provider Details

I. General information

NPI: 1053138503
Provider Name (Legal Business Name): ACCLAIM HOME CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2024
Last Update Date: 09/25/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4340 REDWOOD HWY A14
SAN RAFAEL CA
94903
US

IV. Provider business mailing address

4340 REDWOOD HWY A14
SAN RAFAEL CA
94903
US

V. Phone/Fax

Practice location:
  • Phone: 415-479-5125
  • Fax: 415-479-5196
Mailing address:
  • Phone: 415-479-5125
  • Fax: 415-479-5196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2278H0200X
TaxonomyHome Health Certified Respiratory Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2279H0200X
TaxonomyHome Health Registered Respiratory Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code364SH0200X
TaxonomyHome Health Clinical Nurse Specialist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: MR. RANDOLPH CHU DE LEON
Title or Position: PRESIDENT
Credential:
Phone: 415-479-5125