Provider Demographics
NPI:1669942108
Name:DISCOVER HOME CARE
Entity type:Organization
Organization Name:DISCOVER HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:FERNANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:BORREGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-881-1059
Mailing Address - Street 1:101 KINGSBURY BLVD
Mailing Address - Street 2:
Mailing Address - City:FREDERICKTOWN
Mailing Address - State:MO
Mailing Address - Zip Code:63645-7959
Mailing Address - Country:US
Mailing Address - Phone:573-747-5885
Mailing Address - Fax:
Practice Address - Street 1:101 KINGSBURY BLVD
Practice Address - Street 2:
Practice Address - City:FREDERICKTOWN
Practice Address - State:MO
Practice Address - Zip Code:63645-7959
Practice Address - Country:US
Practice Address - Phone:573-747-5885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-27
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health