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General NPI Number Information
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NPI Number | 1770314114
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Entity Type | Organization
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Legal Business Name | ADVANCED CARE HOME HEALTH, LLC
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Dates
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Enumeration Date | 08/08/2024
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Last Update Date | 08/08/2024
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Provider Practice Location Address
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Address Line | 4349 OLD SANTA FE RD. UNIT G SUITE 202
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-8175
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Country | US
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Telephone | 805-505-9955
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Fax | 805-505-9956
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Provider Business Mailing Address
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Address Line | 4349 OLD SANTA FE RD. UNIT G SUITE 202
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-8175
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Country | US
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Telephone | 805-505-9955
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Fax | 805-505-9956
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Authorized Official
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Title or Position | OWNER
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Name | KIMBERLY MARSDEN
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Credential | LVN
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Telephone | 805-801-5088
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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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