Provider Demographics
NPI:1427044544
Name:PROCARE HOME HEALTH SERVICES INC
Entity Type:Organization
Organization Name:PROCARE HOME HEALTH SERVICES INC
Other - Org Name:TOP CARE HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR / PRESIDENT / CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:INOCENCIO
Authorized Official - Last Name:PERPETUA
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:858-695-2101
Mailing Address - Street 1:9683 TIERRA GRANDE ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-6503
Mailing Address - Country:US
Mailing Address - Phone:858-695-2101
Mailing Address - Fax:858-695-2208
Practice Address - Street 1:9683 TIERRA GRANDE ST
Practice Address - Street 2:SUITE 201
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-6503
Practice Address - Country:US
Practice Address - Phone:858-695-2101
Practice Address - Fax:858-695-2208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
557712Medicare ID - Type Unspecified
HHA57712FMedicare ID - Type Unspecified