Provider Demographics
NPI:1598706095
Name:INTERIM HEALTHCARE INC.
Entity Type:Organization
Organization Name:INTERIM HEALTHCARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SLUPECKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-858-2753
Mailing Address - Street 1:1601 SAWGRASS CORPORATE PKWY
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2827
Mailing Address - Country:US
Mailing Address - Phone:954-858-2871
Mailing Address - Fax:954-858-2710
Practice Address - Street 1:2850 E FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-3400
Practice Address - Country:US
Practice Address - Phone:626-229-9040
Practice Address - Fax:626-685-2094
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTERIM HEALTHCARE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-08
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980000491251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHHA07690FMedicaid
CA057690Medicare Oscar/Certification