Provider Demographics
NPI:1124252499
Name:PACIFIC CARE HOME HEALTH AGENCY, INC.
Entity type:Organization
Organization Name:PACIFIC CARE HOME HEALTH AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/DOPCS
Authorized Official - Prefix:MS
Authorized Official - First Name:UZOAMAKA
Authorized Official - Middle Name:B
Authorized Official - Last Name:ENEWALLY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:562-864-2222
Mailing Address - Street 1:12100 IMPERIAL HWY
Mailing Address - Street 2:SUITE 209
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-3081
Mailing Address - Country:US
Mailing Address - Phone:562-864-2222
Mailing Address - Fax:562-864-1001
Practice Address - Street 1:12100 IMPERIAL HWY
Practice Address - Street 2:SUITE 209
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-3081
Practice Address - Country:US
Practice Address - Phone:562-864-2222
Practice Address - Fax:562-864-1001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-14
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health