MEDICARE: FORECAST HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency	334700100	CA

General Provider Information

NPI Number	:	1033691753
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FORECAST HEALTH

Provider Business Mailing Address
First Line	:	31942 CEDARHILL LN
Second Line	:
City	:	LAKE ELSINORE
State	:	CA
Zip	:	92532-2616
Country	:	US
Telephone Number	:	951-579-9198
Fax Number	:

Provider Business Practice Location Address
First Line	:	31942 CEDARHILL LN
Second Line	:
City	:	LAKE ELSINORE
State	:	CA
Zip	:	92532-2616
Country	:	US
Telephone Number	:	951-579-9198
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	DANA CASTLEBERRY
Credential	:	RN
Telephone Number	:	951-579-9198

Provider Enumeration Date	:	08/29/2018
Last Update Date	:	08/29/2018

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Directions to “FORECAST HEALTH ” Practice Location

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