Provider Demographics
NPI:1811286958
Name:SMITH HOME CARE INC.
Entity type:Organization
Organization Name:SMITH HOME CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LILIBETH
Authorized Official - Middle Name:
Authorized Official - Last Name:TEZAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-273-5006
Mailing Address - Street 1:23591 EL TORO RD STE 208
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-4787
Mailing Address - Country:US
Mailing Address - Phone:949-273-5006
Mailing Address - Fax:
Practice Address - Street 1:23591 EL TORO RD STE 208
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-4787
Practice Address - Country:US
Practice Address - Phone:949-273-5006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SMITH HOME CARE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-29
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty