Provider Demographics
NPI:1760928535
Name:INHERITANCE HOME CARE LLC
Entity Type:Organization
Organization Name:INHERITANCE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PRISCILA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-207-5760
Mailing Address - Street 1:2127 OLYMPIC PKWY # 1006-164
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91915-1359
Mailing Address - Country:US
Mailing Address - Phone:619-207-5760
Mailing Address - Fax:
Practice Address - Street 1:2566 CATAMARAN WAY # 5
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91914-4533
Practice Address - Country:US
Practice Address - Phone:619-207-5760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-17
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374700121253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care