Provider Demographics
NPI:1962641233
Name:AMADA HOME CARE INC.
Entity Type:Organization
Organization Name:AMADA HOME CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:BRADSHAW
Authorized Official - Last Name:FOTHERINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-557-5577
Mailing Address - Street 1:575 ANTON BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-7169
Mailing Address - Country:US
Mailing Address - Phone:714-557-5577
Mailing Address - Fax:714-557-5578
Practice Address - Street 1:575 ANTON BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-7169
Practice Address - Country:US
Practice Address - Phone:714-557-5577
Practice Address - Fax:714-557-5578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-11
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care