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General NPI Number Information
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NPI Number | 1215662796
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Entity Type | Organization
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Legal Business Name | PROCARE NETWORK IN-HOME CARE SERVICES INC
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Dates
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Enumeration Date | 07/19/2022
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Last Update Date | 07/19/2022
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Provider Practice Location Address
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Address Line | 500 E CARSON PLAZA DR STE 102
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City | CARSON
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State | CA
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Zip | 90746-3223
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Country | US
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Telephone | 424-329-0018
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Fax |
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Provider Business Mailing Address
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Address Line | 500 E CARSON PLAZA DR STE 102
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City | CARSON
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State | CA
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Zip | 90746-3223
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Country | US
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Telephone | 424-329-0018
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | IBRAHIM O ADEKEYE
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Credential |
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Telephone | 310-254-7164
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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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