Provider Demographics
NPI:1770023566
Name:POLARIS HOME CARE LLC
Entity Type:Organization
Organization Name:POLARIS HOME CARE LLC
Other - Org Name:POLARIS HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO, FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:KEMPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-295-7846
Mailing Address - Street 1:PO BOX 2318
Mailing Address - Street 2:
Mailing Address - City:EL GRANADA
Mailing Address - State:CA
Mailing Address - Zip Code:94018-2318
Mailing Address - Country:US
Mailing Address - Phone:610-295-7846
Mailing Address - Fax:
Practice Address - Street 1:830 STEWART DR
Practice Address - Street 2:SUITE 214
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085-4513
Practice Address - Country:US
Practice Address - Phone:610-295-7846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health