Provider Demographics
NPI:1487317921
Name:ALTACARE HOME HEALTH
Entity type:Organization
Organization Name:ALTACARE HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:GEMMA
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:657-400-8818
Mailing Address - Street 1:333 CITY BLVD W STE 1700
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-5905
Mailing Address - Country:US
Mailing Address - Phone:657-400-8818
Mailing Address - Fax:855-978-1938
Practice Address - Street 1:333 CITY BLVD W STE 1700
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-5905
Practice Address - Country:US
Practice Address - Phone:657-400-8818
Practice Address - Fax:855-978-1938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health