Provider Demographics
NPI:1932442092
Name:INTERIM ASSISTED CARE OF NORTHERN CALIFORNIA
Entity Type:Organization
Organization Name:INTERIM ASSISTED CARE OF NORTHERN CALIFORNIA
Other - Org Name:INTERIM HEALTHCARE PERSONAL CARE & SUPPORTIVE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SEAWRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-722-1530
Mailing Address - Street 1:2608 VICTOR AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-1447
Mailing Address - Country:US
Mailing Address - Phone:530-722-1530
Mailing Address - Fax:530-226-8293
Practice Address - Street 1:406 E MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-6534
Practice Address - Country:US
Practice Address - Phone:530-272-0300
Practice Address - Fax:530-272-1572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-27
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health