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General NPI Number Information
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NPI Number | 1104116979
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Entity Type | Organization
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Legal Business Name | AT HOME ASSISTANCE, INC.
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Dates
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Enumeration Date | 04/13/2011
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Last Update Date | 04/13/2011
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Provider Practice Location Address
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Address Line | 7307 EDGEWATER DR
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City | OAKLAND
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State | CA
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Zip | 94621-3015
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Country | US
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Telephone | 866-418-6895
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Fax |
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Provider Business Mailing Address
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Address Line | 7307 EDGEWATER DR
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City | OAKLAND
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State | CA
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Zip | 94621-3015
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Country | US
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Telephone | 866-418-6895
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE ASSISTANT
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Name | ELIZABETH BENNETT
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Credential |
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Telephone | 866-418-6895
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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 | 28014400
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License Number State | CA
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