Provider Demographics
NPI:1851461305
Name:CENTRAL BASIN HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:CENTRAL BASIN HOME HEALTH CARE, INC.
Other - Org Name:CENTRAL BASIN HOME HEALTH & HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:LASZLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-765-1856
Mailing Address - Street 1:311 W 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:MOSES LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98837-1905
Mailing Address - Country:US
Mailing Address - Phone:509-765-1856
Mailing Address - Fax:509-765-3323
Practice Address - Street 1:311 W 3RD AVE
Practice Address - Street 2:
Practice Address - City:MOSES LAKE
Practice Address - State:WA
Practice Address - Zip Code:98837-1905
Practice Address - Country:US
Practice Address - Phone:509-765-1856
Practice Address - Fax:509-765-3323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2009-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAIS-249251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0018111OtherLABOR & INDUSTRIES
WA9408600Medicaid
WA507048Medicare ID - Type UnspecifiedHOME HEALTH