Provider Demographics
NPI:1669655486
Name:JC HEALTH CARE SERVICES, INC.
Entity Type:Organization
Organization Name:JC HEALTH CARE SERVICES, INC.
Other - Org Name:EXCEPTIONAL HOME HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANNIE
Authorized Official - Middle Name:TRAM
Authorized Official - Last Name:DARBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-390-7428
Mailing Address - Street 1:2315 KUEHNER DR
Mailing Address - Street 2:SUITE 112
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-3900
Mailing Address - Country:US
Mailing Address - Phone:805-527-3527
Mailing Address - Fax:805-527-3627
Practice Address - Street 1:2315 KUEHNER DR
Practice Address - Street 2:SUITE 112
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-3900
Practice Address - Country:US
Practice Address - Phone:805-390-7165
Practice Address - Fax:805-823-6219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-15
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550001032251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA059130Medicare Oscar/Certification