Provider Demographics
NPI:1053677757
Name:CARE AT HOME, INC.
Entity Type:Organization
Organization Name:CARE AT HOME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:G
Authorized Official - Last Name:SALERNO
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:541-523-4385
Mailing Address - Street 1:1705 MAIN ST
Mailing Address - Street 2:#101
Mailing Address - City:BAKER CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97814-3453
Mailing Address - Country:US
Mailing Address - Phone:541-523-4385
Mailing Address - Fax:541-523-4406
Practice Address - Street 1:1705 MAIN ST
Practice Address - Street 2:#101
Practice Address - City:BAKER CITY
Practice Address - State:OR
Practice Address - Zip Code:97814-3453
Practice Address - Country:US
Practice Address - Phone:541-523-4385
Practice Address - Fax:541-523-4406
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARE AT HOME, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-04-06
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR13-1500251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR13-1500Medicaid