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General NPI Number Information
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NPI Number | 1265778054
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Entity Type | Organization
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Legal Business Name | SUPPORT FOR HOME, INC.
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Dates
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Enumeration Date | 12/24/2012
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Last Update Date | 05/29/2013
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Provider Practice Location Address
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Address Line | 1333 HOWE AVE SUITE 206
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City | SACRAMENTO
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State | CA
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Zip | 95825-3362
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Country | US
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Telephone | 916-482-8484
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Fax | 916-564-6847
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Provider Business Mailing Address
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Address Line | 1333 HOWE AVE SUITE 206
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City | SACRAMENTO
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State | CA
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Zip | 95825-3362
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Country | US
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Telephone | 916-482-8484
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Fax | 916-564-6847
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. BERT CAVE
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Credential |
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Telephone | 916-482-8484
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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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