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General NPI Number Information
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NPI Number | 1073908315
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Entity Type | Organization
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Legal Business Name | EMPACARE HOMECARE
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Dates
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Enumeration Date | 04/03/2015
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Last Update Date | 04/03/2015
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Provider Practice Location Address
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Address Line | 7231 BOULDER AVE. STE 197
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City | HIGHLAND
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State | CA
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Zip | 92346
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Country | US
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Telephone | 909-362-0248
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Fax |
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Provider Business Mailing Address
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Address Line | 7231 BOULDER AVE. STE 197
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City | HIGHLAND
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State | CA
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Zip | 92346
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Country | US
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Telephone | 909-362-0248
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | JACKYLINE SPRINGER
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Credential |
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Telephone | 909-362-0248
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315D00000X
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Taxonomy Name | Inpatient Hospice
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License Number | 12299
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 12299
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License Number State | CA
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