Provider Demographics
NPI:1336386382
Name:ASSURED INHOME CARE, INC.
Entity Type:Organization
Organization Name:ASSURED INHOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:GERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-394-5678
Mailing Address - Street 1:1525 MESA VERDE DR E
Mailing Address - Street 2:#207
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-5218
Mailing Address - Country:US
Mailing Address - Phone:949-394-5678
Mailing Address - Fax:714-424-6162
Practice Address - Street 1:1525 MESA VERDE DR E
Practice Address - Street 2:#207
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-5218
Practice Address - Country:US
Practice Address - Phone:949-394-5678
Practice Address - Fax:714-424-6162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-13
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABL030066253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care