Provider Demographics
NPI:1073908315
Name:EMPACARE HOMECARE
Entity Type:Organization
Organization Name:EMPACARE HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JACKYLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SPRINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-362-0248
Mailing Address - Street 1:7231 BOULDER AVE.
Mailing Address - Street 2:STE 197
Mailing Address - City:HIGHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92346
Mailing Address - Country:US
Mailing Address - Phone:909-362-0248
Mailing Address - Fax:
Practice Address - Street 1:7231 BOULDER AVE.
Practice Address - Street 2:STE 197
Practice Address - City:HIGHLAND
Practice Address - State:CA
Practice Address - Zip Code:92346
Practice Address - Country:US
Practice Address - Phone:909-362-0248
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-03
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12299253Z00000X, 315D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient