Provider Demographics
NPI:1952830069
Name:GENERATION HOME HEALTH AGENCY
Entity Type:Organization
Organization Name:GENERATION HOME HEALTH AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:LI
Authorized Official - Last Name:HUANG-FROST
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:925-378-3661
Mailing Address - Street 1:3553 CASTRO VALLEY BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-4456
Mailing Address - Country:US
Mailing Address - Phone:925-378-3661
Mailing Address - Fax:925-378-3662
Practice Address - Street 1:3553 CASTRO VALLEY BLVD STE B
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-4456
Practice Address - Country:US
Practice Address - Phone:925-378-3661
Practice Address - Fax:925-378-3662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA793084163W00000X
251E00000X, 251F00000X, 251G00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing CareGroup - Multi-Specialty