Provider Demographics
NPI:1568613222
Name:MEDCARE-TEMECULA HOME HEALTH AGENCY, INC
Entity Type:Organization
Organization Name:MEDCARE-TEMECULA HOME HEALTH AGENCY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:RASKINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-302-8300
Mailing Address - Street 1:31285 TEMECULA PKWY
Mailing Address - Street 2:SUITE 225
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-6828
Mailing Address - Country:US
Mailing Address - Phone:951-302-8300
Mailing Address - Fax:951-303-9255
Practice Address - Street 1:31285 TEMECULA PKWY
Practice Address - Street 2:SUITE 225
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-6828
Practice Address - Country:US
Practice Address - Phone:951-302-8300
Practice Address - Fax:951-303-9255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550000572251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health