Provider Demographics
NPI:1881020394
Name:ALIX HOME CARE
Entity Type:Organization
Organization Name:ALIX HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HHA
Authorized Official - Prefix:MS
Authorized Official - First Name:SIMONE
Authorized Official - Middle Name:
Authorized Official - Last Name:SALTUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-212-2895
Mailing Address - Street 1:16170 PEBBLE BEACH DR
Mailing Address - Street 2:APT 65
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-4491
Mailing Address - Country:US
Mailing Address - Phone:424-212-2895
Mailing Address - Fax:424-245-6916
Practice Address - Street 1:16170 PEBBLE BEACH DR
Practice Address - Street 2:APT 65
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-4491
Practice Address - Country:US
Practice Address - Phone:424-212-2895
Practice Address - Fax:424-245-6916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-17
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization