Provider Demographics
NPI:1760752398
Name:GENTLE CARE INC- VENTURA
Entity Type:Organization
Organization Name:GENTLE CARE INC- VENTURA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOPCS
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAIG
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:805-236-6656
Mailing Address - Street 1:5128 S CHARITON AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90056-1358
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:290 MAPLE CT STE 118
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-3536
Practice Address - Country:US
Practice Address - Phone:888-501-7762
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health