Healthcare Provider Details

I. General information

NPI: 1699186510
Provider Name (Legal Business Name): ACCESSIBLE HEALTH CARE CENTRAL COAST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2014
Last Update Date: 05/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 CAPITOLA RD SUITE M
SANTA CRUZ CA
95062-2954
US

IV. Provider business mailing address

1515 CAPITOLA RD SUITE M
SANTA CRUZ CA
95062-2954
US

V. Phone/Fax

Practice location:
  • Phone: 831-566-9450
  • Fax:
Mailing address:
  • Phone: 831-566-9450
  • 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: ALYA ROSS
Title or Position: OWNER - CLIENT CARE DIRECTOR
Credential:
Phone: 831-464-3400