Provider Demographics
NPI:1851970925
Name:XOCHJR, INC.
Entity Type:Organization
Organization Name:XOCHJR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:A
Authorized Official - Last Name:PRECIADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-666-4300
Mailing Address - Street 1:123 COURT ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-3112
Mailing Address - Country:US
Mailing Address - Phone:530-666-4300
Mailing Address - Fax:530-666-1536
Practice Address - Street 1:123 COURT ST
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-3112
Practice Address - Country:US
Practice Address - Phone:530-666-4300
Practice Address - Fax:530-666-1536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-06
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA574700001OtherHOME CARE ORGANIZATION LICENSE #