Provider Demographics
NPI:1619148285
Name:IMMACULATE HEALTH CARE
Entity Type:Organization
Organization Name:IMMACULATE HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:CABATINGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-280-8881
Mailing Address - Street 1:2855 MITCHELL DR
Mailing Address - Street 2:STE 104
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-1600
Mailing Address - Country:US
Mailing Address - Phone:925-280-8881
Mailing Address - Fax:925-280-8882
Practice Address - Street 1:2855 MITCHELL DR
Practice Address - Street 2:STE 104
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-1600
Practice Address - Country:US
Practice Address - Phone:925-280-8881
Practice Address - Fax:925-280-8882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-21
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health