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General NPI Number Information
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NPI Number | 1013376086
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Entity Type | Organization
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Legal Business Name | AMADA HOME HEALTH
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Dates
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Enumeration Date | 02/18/2016
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Last Update Date | 02/18/2016
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Provider Practice Location Address
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Address Line | 901 CALLE AMANECER SUITE 360
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City | SAN CLEMENTE
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State | CA
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Zip | 92673-6278
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Country | US
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Telephone | 949-544-1438
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Fax |
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Provider Business Mailing Address
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Address Line | 901 CALLE AMANECER SUITE 360
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City | SAN CLEMENTE
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State | CA
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Zip | 92673
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TAFA JEFFERSON
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Credential |
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Telephone | 949-544-1538
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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