Provider Demographics
NPI:1760781413
Name:ETERNITY HEALTH CARE SERVICES
Entity Type:Organization
Organization Name:ETERNITY HEALTH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:NORRIS
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:916-363-2094
Mailing Address - Street 1:10316 PLACER LN STE A
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2557
Mailing Address - Country:US
Mailing Address - Phone:916-363-2094
Mailing Address - Fax:916-363-2621
Practice Address - Street 1:10316 PLACER LN STE A
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-2557
Practice Address - Country:US
Practice Address - Phone:916-363-2094
Practice Address - Fax:916-363-2621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-21
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA309281251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health