Provider Demographics
NPI:1407989536
Name:INCARE HOME HEALTH SERVICES
Entity Type:Organization
Organization Name:INCARE HOME HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:YANA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVENTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-673-8989
Mailing Address - Street 1:PO BOX 591495
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94159-1495
Mailing Address - Country:US
Mailing Address - Phone:415-673-8989
Mailing Address - Fax:415-673-8005
Practice Address - Street 1:2675 GEARY BLVD
Practice Address - Street 2:SUITE # 500
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-3400
Practice Address - Country:US
Practice Address - Phone:415-673-8989
Practice Address - Fax:415-673-8005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA220000357251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA051730803OtherBLUE CROSS
CAHHA57798FMedicaid
CA557798Medicare ID - Type UnspecifiedHOME HEALTH AGENCY