Provider Demographics
NPI:1942444955
Name:HOMECARE CASA RHODA #1, INC.
Entity Type:Organization
Organization Name:HOMECARE CASA RHODA #1, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSEE/ADMINISTRATOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:BLANCAFLOR
Authorized Official - Last Name:DEMONTEVERDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-683-0980
Mailing Address - Street 1:165 SANTA ANA AVENUE
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93111
Mailing Address - Country:US
Mailing Address - Phone:805-683-0980
Mailing Address - Fax:805-696-6473
Practice Address - Street 1:126 SANTA ANA AVENUE
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93111
Practice Address - Country:US
Practice Address - Phone:805-683-0980
Practice Address - Fax:805-696-6473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-22
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA425801237310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility