Provider Demographics
NPI:1982944088
Name:TAKE CARE AT HOME INC
Entity Type:Organization
Organization Name:TAKE CARE AT HOME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-414-1717
Mailing Address - Street 1:821 O'HARE PLWY STE 101B
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-4005
Mailing Address - Country:US
Mailing Address - Phone:541-414-1717
Mailing Address - Fax:541-414-1009
Practice Address - Street 1:821 O'HARE PLWY STE 101
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-4005
Practice Address - Country:US
Practice Address - Phone:541-414-1717
Practice Address - Fax:541-414-1009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-26
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR15-2255253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care