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General NPI Number Information
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NPI Number | 1205488731
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Entity Type | Organization
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Legal Business Name | SHASTA FAMILY HEALTH CARE SERVICES
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Dates
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Enumeration Date | 07/15/2019
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Last Update Date | 07/15/2019
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Provider Practice Location Address
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Address Line | 2350 BALLS FERRY RD STE A
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City | ANDERSON
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State | CA
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Zip | 96007-3598
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Country | US
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Telephone | 530-378-5283
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Fax | 530-378-5284
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Provider Business Mailing Address
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Address Line | 2350 BALLS FERRY RD STE A
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City | ANDERSON
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State | CA
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Zip | 96007-3598
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Country | US
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Telephone | 530-378-5283
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Fax | 530-378-5284
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Authorized Official
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Title or Position | ASSISTANT ADMINISTRATOR
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Name | ANGELICA CORTEZ
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Credential |
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Telephone | 530-378-5283
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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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