Provider Demographics
NPI:1801838115
Name:INTERIM HEALTHCARE INC.
Entity Type:Organization
Organization Name:INTERIM HEALTHCARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SLUPECKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-858-2753
Mailing Address - Street 1:1601 SAWGRASS CORPORATE PKWY
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2827
Mailing Address - Country:US
Mailing Address - Phone:954-858-2871
Mailing Address - Fax:954-858-2710
Practice Address - Street 1:2941B FULTON AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-4909
Practice Address - Country:US
Practice Address - Phone:916-486-8181
Practice Address - Fax:916-486-8136
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTERIM HEALTHCARE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-12
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100000270251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZR07198GMedicaid
CA057198Medicare Oscar/Certification