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General NPI Number Information
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NPI Number | 1356343396
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Entity Type | Organization
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Legal Business Name | RENAISSANCE HOME HEALTH CARE INC.
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Dates
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Enumeration Date | 08/10/2005
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Last Update Date | 03/07/2013
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Provider Practice Location Address
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Address Line | 3160 CAMINO DEL RIO S STE 312
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City | SAN DIEGO
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State | CA
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Zip | 92108-3835
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Country | US
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Telephone | 619-285-1505
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Fax | 619-285-1605
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Provider Business Mailing Address
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Address Line | 3160 CAMINO DEL RIO S STE 312
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City | SAN DIEGO
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State | CA
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Zip | 92108-3835
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Country | US
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Telephone | 619-285-1505
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Fax | 619-285-1605
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. PAULA JEAN EGBERT
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Credential | RN, MSN
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Telephone | 619-285-1505
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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 | 080000782
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License Number State | CA
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