MEDICARE: ALERRA HOME HEALTH SERVICES, LLC

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	:	1376771873
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALERRA HOME HEALTH SERVICES, LLC

Provider Business Mailing Address
First Line	:	32332 CAMINO CAPISTRANO
Second Line	:	SUITE 205
City	:	SAN JUAN CAPISTRANO
State	:	CA
Zip	:	92675-3701
Country	:	US
Telephone Number	:	949-545-6646
Fax Number	:	949-545-6866

Provider Business Practice Location Address
First Line	:	32332 CAMINO CAPISTRANO
Second Line	:	SUITE 205
City	:	SAN JUAN CAPISTRANO
State	:	CA
Zip	:	92675-3701
Country	:	US
Telephone Number	:	949-545-6646
Fax Number	:	949-545-6866

Authorized Official
Title or Position	:	PRESIDENT AND CEO
Name	:	MR. MARTIN CANALES
Credential	:
Telephone Number	:	949-545-6646

Provider Enumeration Date	:	06/23/2009
Last Update Date	:	06/23/2009

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