Provider Demographics
NPI:1417237702
Name:SOUTH BAY SENIOR SOLUTIONS INC.
Entity Type:Organization
Organization Name:SOUTH BAY SENIOR SOLUTIONS INC.
Other - Org Name:HOME INSTEAD SENIOR CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-422-6826
Mailing Address - Street 1:595 MILLICH DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-0550
Mailing Address - Country:US
Mailing Address - Phone:408-370-6360
Mailing Address - Fax:408-370-6408
Practice Address - Street 1:595 MILLICH DR
Practice Address - Street 2:SUITE 100
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-0550
Practice Address - Country:US
Practice Address - Phone:408-370-6360
Practice Address - Fax:408-370-6408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-18
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care