MEDICARE: HOME CARE SPECIALISTS, 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	253Z00000X	In Home Supportive Care Agency	194700345	CA

General Provider Information

NPI Number	:	1912443425
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME CARE SPECIALISTS, INC.

Provider Business Mailing Address
First Line	:	1700 BLUFF PL
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90802-6066
Country	:	US
Telephone Number	:	562-624-1970
Fax Number	:	562-624-9803

Provider Business Practice Location Address
First Line	:	1700 BLUFF PL
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90802-6066
Country	:	US
Telephone Number	:	562-624-1970
Fax Number	:	562-624-9803

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NICOLE PEOPLES
Credential	:
Telephone Number	:	562-624-1970

Provider Enumeration Date	:	01/09/2017
Last Update Date	:	01/09/2017

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