Healthcare Provider Details

I. General information

NPI: 1831536168
Provider Name (Legal Business Name): COMMUNITY IN HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2013
Last Update Date: 05/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7590 EASTHILL DR
SAN DIEGO CA
92114-3343
US

IV. Provider business mailing address

7590 EASTHILL DR
SAN DIEGO CA
92114-3343
US

V. Phone/Fax

Practice location:
  • Phone: 619-962-6362
  • Fax: 619-354-3121
Mailing address:
  • Phone: 619-962-6362
  • Fax: 619-354-3121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JANMAR P RAMIREZ
Title or Position: OWNER
Credential:
Phone: 619-962-6362