1992048508 NPI number — SOUTH SPRINGS HOME HEALTH CARE, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992048508 NPI number — SOUTH SPRINGS HOME HEALTH CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTH SPRINGS HOME HEALTH CARE, 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:
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:
1992048508
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/15/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1590 OAKLAND RD
Provider Second Line Business Mailing Address:
SUITE B-213
Provider Business Mailing Address City Name:
SAN JOSE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95131-2443
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-883-4460
Provider Business Mailing Address Fax Number:
408-641-8891

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1590 OAKLAND RD
Provider Second Line Business Practice Location Address:
SUITE B213
Provider Business Practice Location Address City Name:
SAN JOSE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95131-2443
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-883-4460
Provider Business Practice Location Address Fax Number:
408-641-8891
Provider Enumeration Date:
04/02/2013

Additional Information

Authorized Official

Authorized Official Last Name:
DE GUZMAN
Authorized Official First Name:
MARIO
Authorized Official Middle Name:
INGAL
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
408-883-4460

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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