Provider Demographics
NPI:1144205972
Name:CARE HOME HEALTH AGENCY, LLC
Entity Type:Organization
Organization Name:CARE HOME HEALTH AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/DIRECTOR OF NURSING
Authorized Official - Prefix:MR
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:NEBRES
Authorized Official - Last Name:PRADO
Authorized Official - Suffix:III
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:619-754-3725
Mailing Address - Street 1:1734 BRABHAM ST
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92019-4101
Mailing Address - Country:US
Mailing Address - Phone:619-754-3725
Mailing Address - Fax:
Practice Address - Street 1:4215 SPRING ST
Practice Address - Street 2:314C
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-7965
Practice Address - Country:US
Practice Address - Phone:619-754-3725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health