Provider Demographics
NPI:1063657849
Name:ANDAREMOS TERRACE, INC
Entity Type:Organization
Organization Name:ANDAREMOS TERRACE, INC
Other - Org Name:QUANAH HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LIZA
Authorized Official - Middle Name:A
Authorized Official - Last Name:AUGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-454-6867
Mailing Address - Street 1:24 VIA ANDAREMOS
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92673-7034
Mailing Address - Country:US
Mailing Address - Phone:949-545-6867
Mailing Address - Fax:949-606-9101
Practice Address - Street 1:24 VIA ANDAREMOS
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92673-7034
Practice Address - Country:US
Practice Address - Phone:949-545-6867
Practice Address - Fax:949-606-9101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care