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General NPI Number Information
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NPI Number | 1700145166
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Entity Type | Organization
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Legal Business Name | INNOVATIVE SENIOR CARE HOME HEALTH OF SAN JOSE LLC
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Dates
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Enumeration Date | 05/04/2012
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Last Update Date | 06/15/2023
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Provider Practice Location Address
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Address Line | 5674 STONERIDGE DR STE 210
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City | PLEASANTON
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State | CA
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Zip | 94588-8567
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Country | US
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Telephone | 925-224-8675
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Fax |
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Provider Business Mailing Address
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Address Line | 1 PARK PLZ
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City | NASHVILLE
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State | TN
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Zip | 37203-6527
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Country | US
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Telephone | 615-344-9551
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Fax |
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Authorized Official
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Title or Position | CFO, HOME HEALTH & HOSPICE
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Name | WILLIAM BRADLEY PARRISH
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Credential |
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Telephone | 512-565-8439
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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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