Provider Demographics
NPI:1750676615
Name:ALTA HOME CARE INC.
Entity Type:Organization
Organization Name:ALTA HOME CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:REES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-279-9991
Mailing Address - Street 1:PO BOX 78807
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92877-0160
Mailing Address - Country:US
Mailing Address - Phone:866-279-9991
Mailing Address - Fax:866-279-1147
Practice Address - Street 1:1315 CORONA POINTE CT STE 101
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-1764
Practice Address - Country:US
Practice Address - Phone:866-279-9991
Practice Address - Fax:866-279-1147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-17
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA154603253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care