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General NPI Number Information
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NPI Number | 1386700664
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Entity Type | Organization
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Legal Business Name | ELENA'S HOME CARE ICF DDH INC
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 07/16/2008
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Provider Practice Location Address
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Address Line | 25611 BELHAVEN ST
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City | HAYWARD
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State | CA
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Zip | 94545-2529
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Country | US
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Telephone | 510-785-8137
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Fax | 510-780-9836
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Provider Business Mailing Address
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Address Line | 25611 BELHAVEN ST
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City | HAYWARD
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State | CA
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Zip | 94545-2529
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Country | US
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Telephone | 510-785-8137
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Fax | 510-780-9836
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Authorized Official
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Title or Position | CFO
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Name | MRS. ELENA DUMITRESCU
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Credential |
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Telephone | 510-785-8137
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number | 020000441
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License Number State | CA
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