Provider Demographics
NPI:1215388574
Name:HOOVER HOMECARE, INC.
Entity Type:Organization
Organization Name:HOOVER HOMECARE, INC.
Other - Org Name:CARE4YOU
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOOVER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:909-599-0555
Mailing Address - Street 1:470 S SAN DIMAS AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773-4045
Mailing Address - Country:US
Mailing Address - Phone:909-599-0555
Mailing Address - Fax:
Practice Address - Street 1:470 S SAN DIMAS AVE
Practice Address - Street 2:
Practice Address - City:SAN DIMAS
Practice Address - State:CA
Practice Address - Zip Code:91773-4045
Practice Address - Country:US
Practice Address - Phone:909-599-0555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-28
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA194700015253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care