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General NPI Number Information
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NPI Number | 1710697495
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Entity Type | Organization
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Legal Business Name | CENTRAL COAST IN-HOME SENIOR CARE LLC
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Dates
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Enumeration Date | 12/02/2022
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Last Update Date | 12/02/2022
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Provider Practice Location Address
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Address Line | 558 SPRING ST
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City | PASO ROBLES
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State | CA
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Zip | 93446-3171
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Country | US
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Telephone | 805-369-2110
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Fax | 805-309-1799
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Provider Business Mailing Address
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Address Line | 558 SPRING ST
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City | PASO ROBLES
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State | CA
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Zip | 93446-3171
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Country | US
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Telephone | 805-369-2110
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Fax | 805-309-1799
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Authorized Official
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Title or Position | OWNER
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Name | RONALD TORRES
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Credential | MA
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Telephone | 805-369-2110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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