Provider Demographics
NPI:1417352733
Name:MULTI-SKILLED HOME CARE SERVICES, INC.
Entity Type:Organization
Organization Name:MULTI-SKILLED HOME CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:DEANNA MAY
Authorized Official - Middle Name:
Authorized Official - Last Name:SAN DIEGO
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:909-595-0200
Mailing Address - Street 1:19608 CAMINO DE ROSA
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-2103
Mailing Address - Country:US
Mailing Address - Phone:909-595-0200
Mailing Address - Fax:909-595-1211
Practice Address - Street 1:19608 CAMINO DE ROSA
Practice Address - Street 2:
Practice Address - City:WALNUT
Practice Address - State:CA
Practice Address - Zip Code:91789-2103
Practice Address - Country:US
Practice Address - Phone:909-595-0200
Practice Address - Fax:909-595-1211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-29
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980001455251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health