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General NPI Number Information
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NPI Number | 1013428192
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Entity Type | Organization
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Legal Business Name | SENIOR CARE AT HOME
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Dates
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Enumeration Date | 10/17/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1119 S STATE ST
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City | HEMET
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State | CA
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Zip | 92543-7635
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Country | US
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Telephone | 951-291-9881
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Fax | 951-905-1165
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Provider Business Mailing Address
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Address Line | 1119 S STATE STREET
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City | HEMET
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State | CA
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Zip | 92543-7635
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Country | US
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Telephone | 951-291-9881
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Fax | 951-905-1165
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Authorized Official
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Title or Position | OWNER
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Name | MR. GEORGE DZIMIRI
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Credential |
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Telephone | 951-291-9881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 334700002
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License Number State | CA
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