Provider Demographics
NPI:1073856902
Name:INTERIM ASSISTED CARE OF NORTHERN CALIFORNIA
Entity Type:Organization
Organization Name:INTERIM ASSISTED CARE OF NORTHERN CALIFORNIA
Other - Org Name:INTERIM HEALTHCARE PERSONAL CARE & SUPPORT SERIVES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SEAWRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-722-1530
Mailing Address - Street 1:2608 VICTOR AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-1447
Mailing Address - Country:US
Mailing Address - Phone:530-722-1530
Mailing Address - Fax:530-226-8293
Practice Address - Street 1:2120 MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-2378
Practice Address - Country:US
Practice Address - Phone:530-528-8807
Practice Address - Fax:530-528-7791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-28
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health