MEDICARE: SANTA RITA HOME CARE, 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		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	:	1205874294
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANTA RITA HOME CARE, INC.

Provider Business Mailing Address
First Line	:	4383 LINDEN AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-2724
Country	:	US
Telephone Number	:	562-989-1409
Fax Number	:	562-989-1469

Provider Business Practice Location Address
First Line	:	4383 LINDEN AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-2724
Country	:	US
Telephone Number	:	562-989-1409
Fax Number	:	562-989-1469

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. PATRICK ROJAS AFAN
Credential	:
Telephone Number	:	562-989-1409

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	08/22/2020

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