MEDICARE: CARE CENTER HOME HEALTH, INC.

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	251E00000X	Home Health Agency	980001526	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043251986
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE CENTER HOME HEALTH, INC.

Provider Business Mailing Address
First Line	:	14762 BEACH BLVD
Second Line	:
City	:	LA MIRADA
State	:	CA
Zip	:	90638-4250
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	14762 BEACH BLVD
Second Line	:
City	:	LA MIRADA
State	:	CA
Zip	:	90638-4250
Country	:	US
Telephone Number	:	714-562-0096
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. ALEXIS GARCIA CALIPUSAN
Credential	:
Telephone Number	:	818-908-9868

Provider Enumeration Date	:	06/10/2006
Last Update Date	:	06/19/2024

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