MEDICARE: REALINCE HOME HEALTH CARE 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	320700000X	Physical Disabilities Residential Treatment Facility		CA

General Provider Information

NPI Number	:	1518378728
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REALINCE HOME HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	1900 CAMDEN AVE
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95124-2942
Country	:	US
Telephone Number	:	408-326-9971
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 CAMDEN AVE
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95124-2942
Country	:	US
Telephone Number	:	408-326-9971
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. BASHIR ALI
Credential	:
Telephone Number	:	408-326-9971

Provider Enumeration Date	:	05/12/2014
Last Update Date	:	05/12/2014

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