Provider Demographics
NPI:1518625250
Name:RONDHA'S AFTER CARE
Entity Type:Organization
Organization Name:RONDHA'S AFTER CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONDHA
Authorized Official - Middle Name:IRENE
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-615-1353
Mailing Address - Street 1:113 PRESLEY WAY STE 9
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-5847
Mailing Address - Country:US
Mailing Address - Phone:530-615-1353
Mailing Address - Fax:
Practice Address - Street 1:113 PRESLEY WAY STE 9
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-5847
Practice Address - Country:US
Practice Address - Phone:530-615-1353
Practice Address - Fax:530-615-1353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA294700005OtherHOME CARE ORGANIZATION LICENSE