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General NPI Number Information
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NPI Number | 1609296318
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Entity Type | Organization
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Legal Business Name | HEALTHPEAK HOME HEALTH, INC.
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Dates
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Enumeration Date | 04/21/2014
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Last Update Date | 12/29/2015
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Provider Practice Location Address
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Address Line | 1486 S IMPERIAL AVE
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City | EL CENTRO
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State | CA
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Zip | 92243-4200
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Country | US
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Telephone | 760-352-3108
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Fax | 760-352-3234
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Provider Business Mailing Address
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Address Line | 1486 S IMPERIAL AVE
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City | EL CENTRO
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State | CA
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Zip | 92243-4200
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Country | US
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Telephone | 760-352-3108
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Fax | 760-352-3234
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Authorized Official
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Title or Position | DIRECTOR OF PATIENT CARE SERVICES
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Name | MR. JEFFREY DULAY CHAN
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Credential |
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Telephone | 760-336-9330
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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 | 550001940
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License Number State | CA
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