Provider Demographics
NPI:1720377443
Name:SE & CEJ HOME CARE LLC
Entity Type:Organization
Organization Name:SE & CEJ HOME CARE LLC
Other - Org Name:COMFORCARE SAN DIEGO / LA JOLLA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-270-1700
Mailing Address - Street 1:4907 MORENA BLVD
Mailing Address - Street 2:SUITE 1410
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-3463
Mailing Address - Country:US
Mailing Address - Phone:858-270-1700
Mailing Address - Fax:858-270-1717
Practice Address - Street 1:4907 MORENA BLVD
Practice Address - Street 2:SUITE 1410
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-3463
Practice Address - Country:US
Practice Address - Phone:858-270-1700
Practice Address - Fax:858-270-1717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-04
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care