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General NPI Number Information
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NPI Number | 1912439613
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Entity Type | Organization
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Legal Business Name | HOMESTEAD FAMILY CARE LLC
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Dates
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Enumeration Date | 03/31/2017
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Last Update Date | 04/03/2017
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Provider Practice Location Address
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Address Line | 3478 BUSKIRK AVE SUITE 1000
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City | PLEASANT HILL
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State | CA
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Zip | 94523-4344
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Country | US
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Telephone | 925-726-9712
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Fax |
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Provider Business Mailing Address
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Address Line | 3478 BUSKIRK AVE SUITE 1000
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City | PLEASANT HILL
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State | CA
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Zip | 94523-4344
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Country | US
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Telephone | 925-726-9712
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | CHRISTINA BROX
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Credential |
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Telephone | 925-726-9712
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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 | 74700074
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License Number State | CA
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