Provider Demographics
NPI:1568715829
Name:YOUR HOME ADVANTAGE OF CALIFORNIA, INC.
Entity Type:Organization
Organization Name:YOUR HOME ADVANTAGE OF CALIFORNIA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:SIRICHAI
Authorized Official - Middle Name:
Authorized Official - Last Name:ASSAPIMONWAIT
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:954-990-2057
Mailing Address - Street 1:600 W HILLSBORO BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-1610
Mailing Address - Country:US
Mailing Address - Phone:954-990-2057
Mailing Address - Fax:954-843-7311
Practice Address - Street 1:600 W HILLSBORO BLVD STE 110
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-1610
Practice Address - Country:US
Practice Address - Phone:954-990-2057
Practice Address - Fax:954-843-7311
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:F & B CARE SERVICES HOLDING, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization