MEDICARE: UNITED HOMECARE OF NORTHERN CALIFORNIA, LC

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	100000267	CA

General Provider Information

NPI Number	:	1174520027
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNITED HOMECARE OF NORTHERN CALIFORNIA, LC

Provider Business Mailing Address
First Line	:	598 W 900 S STE 220
Second Line	:
City	:	WOODS CROSS
State	:	UT
Zip	:	84010-8195
Country	:	US
Telephone Number	:	801-397-4697
Fax Number	:	801-296-9117

Provider Business Practice Location Address
First Line	:	245 NEW YORK RANCH RD
Second Line	:	STE C
City	:	JACKSON
State	:	CA
Zip	:	95642-2147
Country	:	US
Telephone Number	:	209-223-3866
Fax Number	:	209-223-3882

Authorized Official
Title or Position	:	CEO
Name	:	DEE R BANGERTER
Credential	:
Telephone Number	:	801-397-4000

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	02/20/2025

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