Provider Demographics
NPI:1831196146
Name:UNITED HOME CARE OF NORTHERN CALIFORNIA, LC
Entity type:Organization
Organization Name:UNITED HOME CARE OF NORTHERN CALIFORNIA, LC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEE
Authorized Official - Middle Name:R
Authorized Official - Last Name:BANGERTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-397-4000
Mailing Address - Street 1:350 E 300 S
Mailing Address - Street 2:STE 100
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-4914
Mailing Address - Country:US
Mailing Address - Phone:801-397-4100
Mailing Address - Fax:801-397-4197
Practice Address - Street 1:245 NEW YORK RANCH RD
Practice Address - Street 2:STE C
Practice Address - City:JACKSON
Practice Address - State:CA
Practice Address - Zip Code:95642-2147
Practice Address - Country:US
Practice Address - Phone:209-223-3866
Practice Address - Fax:209-223-9453
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROCKY MOUNTAIN HOME HEALTH, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-30
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100000267251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA131OtherAREA 12 AGENCY ON AGING