Provider Demographics
NPI:1598058869
Name:PALADIN HOME CARE
Entity Type:Organization
Organization Name:PALADIN HOME CARE
Other - Org Name:BEACON HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAUN
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHARLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-526-2273
Mailing Address - Street 1:828 SAN PABLO AVE
Mailing Address - Street 2:SUITE 120B
Mailing Address - City:ALBANY
Mailing Address - State:CA
Mailing Address - Zip Code:94706-1567
Mailing Address - Country:US
Mailing Address - Phone:510-526-2273
Mailing Address - Fax:510-550-4848
Practice Address - Street 1:828 SAN PABLO AVE
Practice Address - Street 2:SUITE 120B
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94706-1567
Practice Address - Country:US
Practice Address - Phone:510-526-2273
Practice Address - Fax:510-550-4848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-19
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based