Provider Demographics
NPI:1831789783
Name:HUMBLE HOME CARE
Entity type:Organization
Organization Name:HUMBLE HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:TERRANOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-596-2071
Mailing Address - Street 1:PO BOX 145
Mailing Address - Street 2:
Mailing Address - City:O BRIEN
Mailing Address - State:OR
Mailing Address - Zip Code:97534-0145
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1550 WALDO ROAD
Practice Address - Street 2:
Practice Address - City:O BRIEN
Practice Address - State:OR
Practice Address - Zip Code:97534
Practice Address - Country:US
Practice Address - Phone:541-596-2071
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health