Provider Demographics
NPI:1326223553
Name:SERV HOME HEALTH, INC.
Entity Type:Organization
Organization Name:SERV HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARIDAD
Authorized Official - Middle Name:
Authorized Official - Last Name:CORPUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-558-2715
Mailing Address - Street 1:11501 DUBLIN BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-2826
Mailing Address - Country:US
Mailing Address - Phone:925-558-2715
Mailing Address - Fax:925-558-2716
Practice Address - Street 1:11501 DUBLIN BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-2826
Practice Address - Country:US
Practice Address - Phone:925-558-2715
Practice Address - Fax:925-558-2716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-07
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550000403251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA550000403OtherDHS LICENSE