Provider Demographics
NPI:1801896105
Name:INFINITY HOME CARE PROVIDERS, INC,
Entity type:Organization
Organization Name:INFINITY HOME CARE PROVIDERS, INC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DELIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:626-227-0220
Mailing Address - Street 1:9300 FLAIR DR
Mailing Address - Street 2:SUITE 388
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91731-2802
Mailing Address - Country:US
Mailing Address - Phone:626-227-0220
Mailing Address - Fax:626-227-0226
Practice Address - Street 1:9300 FLAIR DR
Practice Address - Street 2:SUITE 388
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-2802
Practice Address - Country:US
Practice Address - Phone:626-227-0220
Practice Address - Fax:626-227-0226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-28
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA058246251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHHA08246FMedicaid
CAHHA08246FMedicaid