=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851825574
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CARE DIRECT AT HOME INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/19/2017
-----------------------------------------------------
Last Update Date | 04/19/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 171 MAYHEW WAY SUITE 205
-----------------------------------------------------
City | PLEASANT HILL
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94523-4347
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 707-300-6419
-----------------------------------------------------
Fax | 707-300-6072
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 171 MAYHEW WAY SUITE 205
-----------------------------------------------------
City | PLEASANT HILL
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94523-4347
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 707-300-6419
-----------------------------------------------------
Fax | 707-300-6072
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. NAEEM SHAKOOR
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 707-300-6419
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------