Healthcare Provider Details

I. General information

NPI: 1396482618
Provider Name (Legal Business Name): INTEGRAL HOME HEALTH AND HOSPICE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2022
Last Update Date: 09/13/2022
Certification Date: 09/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3862 SMITH ST STE A
UNION CITY CA
94587-2655
US

IV. Provider business mailing address

3862 SMITH ST STE A
UNION CITY CA
94587-2655
US

V. Phone/Fax

Practice location:
  • Phone: 510-358-6708
  • Fax:
Mailing address:
  • Phone: 510-358-6708
  • 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: ROSE DIRIC
Title or Position: OWNER/PRESIDENT/TREASURER/ADMIN
Credential:
Phone: 510-358-6708