Provider Demographics
NPI:1750685822
Name:CENTRAL CALIFORNIA HEALTHCARE INCORPORATED
Entity Type:Organization
Organization Name:CENTRAL CALIFORNIA HEALTHCARE INCORPORATED
Other - Org Name:THERAPEUTIC HOME HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:SORENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-224-8585
Mailing Address - Street 1:5150 N 6TH ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-7510
Mailing Address - Country:US
Mailing Address - Phone:559-224-8585
Mailing Address - Fax:
Practice Address - Street 1:5150 N 6TH ST
Practice Address - Street 2:SUITE 110
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-7510
Practice Address - Country:US
Practice Address - Phone:559-224-8585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-05
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health