Provider Demographics
NPI:1740022581
Name:SD HOMECARE SERVICES
Entity type:Organization
Organization Name:SD HOMECARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:ENRIQUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-707-7599
Mailing Address - Street 1:16136 PASEO DEL SUR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-6155
Mailing Address - Country:US
Mailing Address - Phone:858-899-0023
Mailing Address - Fax:
Practice Address - Street 1:10085 CARROLL CANYON RD STE 260
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-1138
Practice Address - Country:US
Practice Address - Phone:858-707-7599
Practice Address - Fax:858-703-1078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care