Provider Demographics
NPI:1073630596
Name:ADEPT HOME HEALTH SERVICES INC
Entity Type:Organization
Organization Name:ADEPT HOME HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:
Authorized Official - Last Name:HYAMS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:909-608-0006
Mailing Address - Street 1:818 N MOUNTAIN AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-4164
Mailing Address - Country:US
Mailing Address - Phone:909-608-0006
Mailing Address - Fax:909-608-0008
Practice Address - Street 1:818 N MOUNTAIN AVE STE 120
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4164
Practice Address - Country:US
Practice Address - Phone:909-608-0006
Practice Address - Fax:909-608-0008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA240000655251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHHA57735FMedicaid
CAHHA57735FMedicaid