Provider Demographics
NPI:1396187415
Name:HOME CARE BY THE BAY,LLC
Entity Type:Organization
Organization Name:HOME CARE BY THE BAY,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERLA MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:E
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-701-4200
Mailing Address - Street 1:875A ISLAND DR
Mailing Address - Street 2:SUITE 280
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94502-6700
Mailing Address - Country:US
Mailing Address - Phone:510-239-4391
Mailing Address - Fax:510-239-4359
Practice Address - Street 1:1070 MARINA VILLAGE PKWY
Practice Address - Street 2:SUITE 102B
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-1076
Practice Address - Country:US
Practice Address - Phone:510-239-4391
Practice Address - Fax:510-239-4359
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOME CARE BY THE BAY,LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-07-18
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care