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General NPI Number Information
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NPI Number | 1639671431
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Entity Type | Organization
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Legal Business Name | TERICARE HOME HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 03/07/2018
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Last Update Date | 06/19/2019
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Provider Practice Location Address
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Address Line | 2103 REDWOOD ST STE 206
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City | VALLEJO
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State | CA
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Zip | 94590-3608
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Country | US
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Telephone | 707-654-9907
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Fax | 877-406-6515
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Provider Business Mailing Address
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Address Line | 2103 REDWOOD ST STE 206
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City | VALLEJO
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State | CA
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Zip | 94590-3608
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Country | US
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Telephone | 707-654-9907
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Fax | 877-406-6515
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Authorized Official
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Title or Position | OWNER
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Name | JEANNE SERRANO
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Credential |
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Telephone | 415-233-3475
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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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