Provider Demographics
NPI:1336493394
Name:AT HOME NURSING CARE, INC.
Entity Type:Organization
Organization Name:AT HOME NURSING CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:REYNOLDS CONNELLY
Authorized Official - Suffix:
Authorized Official - Credentials:CMC, CHCM
Authorized Official - Phone:760-634-8000
Mailing Address - Street 1:531 ENCINITAS BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-3773
Mailing Address - Country:US
Mailing Address - Phone:760-634-8000
Mailing Address - Fax:760-634-8001
Practice Address - Street 1:531 ENCINITAS BLVD STE 120
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-3773
Practice Address - Country:US
Practice Address - Phone:760-634-8000
Practice Address - Fax:760-634-8001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-30
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA55-9247Medicaid