Provider Demographics
NPI:1699186510
Name:ACCESSIBLE HEALTH CARE CENTRAL COAST
Entity Type:Organization
Organization Name:ACCESSIBLE HEALTH CARE CENTRAL COAST
Other - Org Name:ACMN,INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER - CLIENT CARE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALYA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-464-3400
Mailing Address - Street 1:1515 CAPITOLA RD
Mailing Address - Street 2:SUITE M
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-2954
Mailing Address - Country:US
Mailing Address - Phone:831-566-9450
Mailing Address - Fax:
Practice Address - Street 1:1515 CAPITOLA RD
Practice Address - Street 2:SUITE M
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-2954
Practice Address - Country:US
Practice Address - Phone:831-566-9450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-13
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC3351711Medicaid