=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962220269
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PALLIARE HOME CARE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/26/2024
-----------------------------------------------------
Last Update Date | 05/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7954 STELLA ST
-----------------------------------------------------
City | RIVERSIDE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92504-3541
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-567-0457
-----------------------------------------------------
Fax | 951-324-1314
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 231 E ALESSANDRO BLVD # 670
-----------------------------------------------------
City | RIVERSIDE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92508-5084
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-567-0457
-----------------------------------------------------
Fax | 951-324-1314
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | DEBRA CABRERA-PFEIFFER
-----------------------------------------------------
Credential | MA
-----------------------------------------------------
Telephone | 951-567-0457
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 314000000X
-----------------------------------------------------
Taxonomy Name | Skilled Nursing Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------