Provider Demographics
NPI:1437258464
Name:REHABFOCUS HOME HEALTH, INC
Entity Type:Organization
Organization Name:REHABFOCUS HOME HEALTH, INC
Other - Org Name:FOCUS HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:SPARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-349-1200
Mailing Address - Street 1:120 VANTIS DR STE 200
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-2677
Mailing Address - Country:US
Mailing Address - Phone:949-349-1200
Mailing Address - Fax:949-349-1122
Practice Address - Street 1:4643 QUAIL LAKES DR STE 101
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-5269
Practice Address - Country:US
Practice Address - Phone:209-472-7005
Practice Address - Fax:209-472-9940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100000770251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA100000770OtherHOME HEALTH AGENCY LICENS
CAHHA08216Medicaid
CA058216Medicare ID - Type Unspecified