Provider Demographics
NPI:1588014369
Name:AT HOME CARE LLC
Entity Type:Organization
Organization Name:AT HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-825-9850
Mailing Address - Street 1:27240 TURNBERRY LN STE 200
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1045
Mailing Address - Country:US
Mailing Address - Phone:800-825-9850
Mailing Address - Fax:
Practice Address - Street 1:27240 TURNBERRY LN STE 200
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-1045
Practice Address - Country:US
Practice Address - Phone:800-825-9850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-13
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care