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General NPI Number Information
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NPI Number | 1154867828
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Entity Type | Organization
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Legal Business Name | CHILDREN'S HOME HEALTHCARE
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Dates
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Enumeration Date | 01/18/2017
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Last Update Date | 01/18/2017
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Provider Practice Location Address
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Address Line | 8920 ACTIVITY RD SUITE I
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City | SAN DIEGO
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State | CA
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Zip | 92126-4458
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Country | US
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Telephone | 858-882-7834
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Fax | 858-345-3734
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Provider Business Mailing Address
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Address Line | 8920 ACTIVITY RD SUITE I
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City | SAN DIEGO
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State | CA
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Zip | 92126-4458
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Country | US
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Telephone | 858-882-7834
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Fax | 858-345-3734
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Authorized Official
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Title or Position | DIRECTOR OF NURSING
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Name | CLARENCE DEMETRIO
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Credential | RN
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Telephone | 858-882-7834
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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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