Provider Demographics
NPI:1972055887
Name:PACE CARE, INC.
Entity Type:Organization
Organization Name:PACE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:DOI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-989-3213
Mailing Address - Street 1:1055 WILSHIRE BLVD
Mailing Address - Street 2:STE. 900A
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-2431
Mailing Address - Country:US
Mailing Address - Phone:213-725-2273
Mailing Address - Fax:213-353-1686
Practice Address - Street 1:1055 WILSHIRE BLVD
Practice Address - Street 2:STE. 900A
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-2431
Practice Address - Country:US
Practice Address - Phone:213-725-2273
Practice Address - Fax:213-353-1686
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PACE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-26
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA194700134253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care