Provider Demographics
NPI:1306534912
Name:UNFORGETTABLE HOME CARE LLC
Entity type:Organization
Organization Name:UNFORGETTABLE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSEE
Authorized Official - Prefix:
Authorized Official - First Name:ODINCHEZO
Authorized Official - Middle Name:
Authorized Official - Last Name:AJAELO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-706-8735
Mailing Address - Street 1:1511 SILVER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-2464
Mailing Address - Country:US
Mailing Address - Phone:510-706-8735
Mailing Address - Fax:
Practice Address - Street 1:1511 SILVER CREEK DR
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-2464
Practice Address - Country:US
Practice Address - Phone:510-706-8735
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care