Provider Demographics
NPI:1265021141
Name:NEW WAVE HOME CARE, INC
Entity Type:Organization
Organization Name:NEW WAVE HOME CARE, INC
Other - Org Name:NEW WAVE HOME CARE INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:GILDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-314-0730
Mailing Address - Street 1:1350 N ALTADENA DR STE B
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-1484
Mailing Address - Country:US
Mailing Address - Phone:626-314-0730
Mailing Address - Fax:877-676-0635
Practice Address - Street 1:1350 N ALTADENA DR STE B
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-1484
Practice Address - Country:US
Practice Address - Phone:626-314-0730
Practice Address - Fax:877-676-0635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-14
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care