Provider Demographics
NPI:1093127748
Name:SPECIALE & SPECIALE
Entity Type:Organization
Organization Name:SPECIALE & SPECIALE
Other - Org Name:SPECIALE INC SUBWAY
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:SPECIALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-794-1671
Mailing Address - Street 1:PO BOX 7983
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93290-7983
Mailing Address - Country:US
Mailing Address - Phone:559-794-1671
Mailing Address - Fax:
Practice Address - Street 1:2750 W JAMES AVE APT C
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-7928
Practice Address - Country:US
Practice Address - Phone:559-794-1671
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-29
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA000000012251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health