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General NPI Number Information
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NPI Number | 1134468903
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Entity Type | Organization
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Legal Business Name | WARTA ENTERPRISE, INC.
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Dates
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Enumeration Date | 02/13/2013
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Last Update Date | 02/13/2013
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Provider Practice Location Address
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Address Line | 120 E 12TH ST
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City | TRACY
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State | CA
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Zip | 95376-3604
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Country | US
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Telephone | 209-832-1333
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Fax | 209-832-1118
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Provider Business Mailing Address
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Address Line | 120 E 12TH ST
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City | TRACY
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State | CA
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Zip | 95376-3604
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Country | US
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Telephone | 209-832-1333
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Fax | 209-832-1118
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | MR. DAVID WARTA
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Credential |
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Telephone | 209-832-1333
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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 | 63710
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License Number State | CA
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