Provider Demographics
NPI:1619636511
Name:AMBERSTONE HOME CARE INC.
Entity Type:Organization
Organization Name:AMBERSTONE HOME CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MYLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-373-0775
Mailing Address - Street 1:16750 COYOTE BUSH DR UNIT 90
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-2640
Mailing Address - Country:US
Mailing Address - Phone:808-373-0775
Mailing Address - Fax:
Practice Address - Street 1:16750 COYOTE BUSH DR UNIT 90
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-2640
Practice Address - Country:US
Practice Address - Phone:808-373-0775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-08
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care