Provider Demographics
NPI:1154683613
Name:BURDETTE-DE COCK INC.
Entity Type:Organization
Organization Name:BURDETTE-DE COCK INC.
Other - Org Name:HOME INSTEAD SENIOR CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:DE COCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-542-0563
Mailing Address - Street 1:3825 DEL AMO BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-2167
Mailing Address - Country:US
Mailing Address - Phone:310-542-0653
Mailing Address - Fax:310-542-1534
Practice Address - Street 1:3825 DEL AMO BLVD STE 104
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-2167
Practice Address - Country:US
Practice Address - Phone:310-542-0653
Practice Address - Fax:310-542-1534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care