Provider Demographics
NPI:1205839172
Name:VALLEY CARE HOME HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:VALLEY CARE HOME HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PATIENT CARE
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEILANI
Authorized Official - Middle Name:TEVES
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:BSN RN
Authorized Official - Phone:951-296-0006
Mailing Address - Street 1:ONE RIDGEGATE DRIVE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-5507
Mailing Address - Country:US
Mailing Address - Phone:951-676-6438
Mailing Address - Fax:951-676-7193
Practice Address - Street 1:40880B COUNTY CENTER DR
Practice Address - Street 2:STE K
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-6022
Practice Address - Country:US
Practice Address - Phone:951-296-0006
Practice Address - Fax:951-296-0226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA058146251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA058146Medicare Oscar/Certification