Provider Demographics
NPI:1225229172
Name:OPTIMUM CARE HOME HEALTH
Entity Type:Organization
Organization Name:OPTIMUM CARE HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GLENN BACOLOR
Authorized Official - Middle Name:HABACON
Authorized Official - Last Name:BACOLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-864-7851
Mailing Address - Street 1:2020 S LA QUINTA CT
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-2024
Mailing Address - Country:US
Mailing Address - Phone:714-864-7851
Mailing Address - Fax:
Practice Address - Street 1:2020 S LA QUINTA CT
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-2024
Practice Address - Country:US
Practice Address - Phone:714-864-7851
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-06
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health