Provider Demographics
NPI:1699040766
Name:BROBERG'S INC.
Entity Type:Organization
Organization Name:BROBERG'S INC.
Other - Org Name:CALIFORNIA SENIORS CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:BROBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-996-2180
Mailing Address - Street 1:12384 SARATOGA SUNNYVALE RD
Mailing Address - Street 2:
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-3084
Mailing Address - Country:US
Mailing Address - Phone:408-996-2180
Mailing Address - Fax:408-996-2193
Practice Address - Street 1:12384 SARATOGA SUNNYVALE RD
Practice Address - Street 2:
Practice Address - City:SARATOGA
Practice Address - State:CA
Practice Address - Zip Code:95070-3084
Practice Address - Country:US
Practice Address - Phone:408-996-2180
Practice Address - Fax:408-996-2193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-21
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC1254184251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health