Provider Demographics
NPI:1164510947
Name:ALLCARE HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:ALLCARE HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ITANWAN
Authorized Official - Middle Name:I
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:909-390-5772
Mailing Address - Street 1:4365 E LOWELL ST
Mailing Address - Street 2:SUITE H
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91761-2226
Mailing Address - Country:US
Mailing Address - Phone:909-390-5772
Mailing Address - Fax:909-390-5774
Practice Address - Street 1:4365 E LOWELL ST
Practice Address - Street 2:SUITE H
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91761-2226
Practice Address - Country:US
Practice Address - Phone:909-390-5772
Practice Address - Fax:909-390-5774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550000223251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA550000223OtherHHA LICENSE NUMBER