Provider Demographics
NPI:1356006589
Name:INTELLIHEALTH CARE MANAGEMENT SERVICES INC
Entity Type:Organization
Organization Name:INTELLIHEALTH CARE MANAGEMENT SERVICES INC
Other - Org Name:EMMANUEL CARE CENTER - TRAVIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:PRAXEDES
Authorized Official - Middle Name:BERNARDO
Authorized Official - Last Name:DEMESA
Authorized Official - Suffix:
Authorized Official - Credentials:MPA NHA
Authorized Official - Phone:209-406-6610
Mailing Address - Street 1:10740 OAKWILDE AVE
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95212-9249
Mailing Address - Country:US
Mailing Address - Phone:209-406-6610
Mailing Address - Fax:
Practice Address - Street 1:10740 OAKWILDE AVE
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95212-9249
Practice Address - Country:US
Practice Address - Phone:209-406-6610
Practice Address - Fax:209-729-5777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-02
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility