MEDICARE: CATALINA IN HOME SERVICES

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

General Provider Information

NPI Number	:	1356691224
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CATALINA IN HOME SERVICES

Provider Business Mailing Address
First Line	:	1602 E FORT LOWELL RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85719-2318
Country	:	US
Telephone Number	:	520-327-6351
Fax Number	:	520-327-3967

Provider Business Practice Location Address
First Line	:	1602 E FORT LOWELL RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85719-2318
Country	:	US
Telephone Number	:	520-327-6351
Fax Number	:	520-327-3967

Authorized Official
Title or Position	:	PRESIENT-CEO
Name	:	JUDITH BRIGGS CLINCO
Credential	:
Telephone Number	:	520-247-6385

Provider Enumeration Date	:	09/18/2012
Last Update Date	:	09/18/2012

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