Provider Demographics
NPI:1720589997
Name:YOUR HOME CARE
Entity Type:Organization
Organization Name:YOUR HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS DEVELOPMENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:FOREMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-424-9322
Mailing Address - Street 1:24191 PASEO DA VALENCIA
Mailing Address - Street 2:SUITE D
Mailing Address - City:LAGUNA WOODS
Mailing Address - State:CA
Mailing Address - Zip Code:92637
Mailing Address - Country:US
Mailing Address - Phone:949-424-9322
Mailing Address - Fax:
Practice Address - Street 1:24191 PASEO DA VALENCIA
Practice Address - Street 2:SUITE B
Practice Address - City:LAGUNA WOODS
Practice Address - State:CA
Practice Address - Zip Code:92637
Practice Address - Country:US
Practice Address - Phone:949-424-9322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-23
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA304700158251E00000X
CA306005324261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care