Provider Demographics
NPI:1073176152
Name:IHCSCCA LLC
Entity Type:Organization
Organization Name:IHCSCCA LLC
Other - Org Name:INTERIM HEALTHCARE OF SANTA CRUZ
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SOMANGLOW
Authorized Official - Middle Name:M
Authorized Official - Last Name:NAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-731-5358
Mailing Address - Street 1:2524 PRESTON RD APT 1401
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-3574
Mailing Address - Country:US
Mailing Address - Phone:831-731-5358
Mailing Address - Fax:
Practice Address - Street 1:542 OCEAN ST STE E
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-6622
Practice Address - Country:US
Practice Address - Phone:831-731-5358
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-15
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care