1801014915 NPI number — WELCOME CARE HOMES INC

Table of content: (NPI 1801014915)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801014915 NPI number — WELCOME CARE HOMES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WELCOME CARE HOMES INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801014915
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/11/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
55 SHAW AVE
Provider Second Line Business Mailing Address:
SUITE 122
Provider Business Mailing Address City Name:
CLOVIS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93612-3819
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
559-299-4954
Provider Business Mailing Address Fax Number:
559-299-0345

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1707 GRIFFITH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLOVIS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93611-5124
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-299-4954
Provider Business Practice Location Address Fax Number:
299-299-0345
Provider Enumeration Date:
04/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
NEHAM
Authorized Official First Name:
MARTIN
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
559-299-4954

Provider Taxonomy Codes

  • Taxonomy code: 315P00000X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 91517873A55041 . This is a "PAMELA FOGEL" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 92331123A65049 . This is a "DAVID MOJICA" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 91773936A95045 . This is a "ORALIA ZUNIGA" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 90777372A85034 . This is a "TERESA PITTENGER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 91512171A85041 . This is a "STEVEN DAVIDSON" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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