Provider Demographics
NPI:1417249913
Name:BIGELOW FAMILY HOME CARE
Entity Type:Organization
Organization Name:BIGELOW FAMILY HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BACCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-600-3435
Mailing Address - Street 1:42225 10TH ST W STE 101
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-7080
Mailing Address - Country:US
Mailing Address - Phone:661-360-8845
Mailing Address - Fax:661-480-5521
Practice Address - Street 1:37412 QUEEN ANNE PL
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-6900
Practice Address - Country:US
Practice Address - Phone:661-317-1883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10016005253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care