Provider Demographics
NPI:1184944787
Name:TOTALCARE HOME HEALTH CORP
Entity type:Organization
Organization Name:TOTALCARE HOME HEALTH CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:OLADOKUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-941-7911
Mailing Address - Street 1:7365 CARNELIAN ST
Mailing Address - Street 2:SUITE 113
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-1156
Mailing Address - Country:US
Mailing Address - Phone:909-941-7911
Mailing Address - Fax:909-941-7411
Practice Address - Street 1:7365 CARNELIAN ST
Practice Address - Street 2:SUITE 113
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-1156
Practice Address - Country:US
Practice Address - Phone:909-941-7911
Practice Address - Fax:909-941-7411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-04
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550001646251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health