Provider Demographics
NPI:1790469930
Name:DAVIS IN-HOME CARE, INC.
Entity Type:Organization
Organization Name:DAVIS IN-HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DREW
Authorized Official - Middle Name:C
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-297-9125
Mailing Address - Street 1:2627 MANHATTAN BEACH BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-1606
Mailing Address - Country:US
Mailing Address - Phone:310-297-9127
Mailing Address - Fax:310-297-9128
Practice Address - Street 1:2627 MANHATTAN BEACH BLVD STE 204
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90278-1606
Practice Address - Country:US
Practice Address - Phone:310-297-9127
Practice Address - Fax:310-297-9128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care