Provider Demographics
NPI:1033508460
Name:HOME SWEET HOME SENIOR CARE DALY CITY, INC.
Entity Type:Organization
Organization Name:HOME SWEET HOME SENIOR CARE DALY CITY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IRENA
Authorized Official - Middle Name:
Authorized Official - Last Name:MATIJAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-806-0904
Mailing Address - Street 1:1560 BRYANT ST
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-1926
Mailing Address - Country:US
Mailing Address - Phone:650-992-2727
Mailing Address - Fax:650-756-8406
Practice Address - Street 1:1560 BRYANT ST
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-1926
Practice Address - Country:US
Practice Address - Phone:650-992-2727
Practice Address - Fax:650-756-8406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-22
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA415600821311500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)