Provider Demographics
NPI:1831282615
Name:PACIFIC NURSING SERVICES, INC.
Entity Type:Organization
Organization Name:PACIFIC NURSING SERVICES, INC.
Other - Org Name:LA JOLLA NURSES HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:ALTON
Authorized Official - Last Name:HEALY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-641-5441
Mailing Address - Street 1:1800 FOREST HILL BLVD
Mailing Address - Street 2:SUITE B-1
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-6094
Mailing Address - Country:US
Mailing Address - Phone:561-641-5441
Mailing Address - Fax:561-641-1168
Practice Address - Street 1:2223 AVENIDA DE LA PLAYA
Practice Address - Street 2:SUITE 103
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-3200
Practice Address - Country:US
Practice Address - Phone:858-454-9339
Practice Address - Fax:858-454-1050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health