Provider Demographics
NPI:1396258729
Name:SOUTH BAY HOME CARE, INC.
Entity type:Organization
Organization Name:SOUTH BAY HOME CARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:BIANCO
Authorized Official - Suffix:
Authorized Official - Credentials:CSA
Authorized Official - Phone:310-792-8666
Mailing Address - Street 1:370 S. CRENSHAW BLVD., STE. E106
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503
Mailing Address - Country:US
Mailing Address - Phone:310-503-6893
Mailing Address - Fax:760-284-1542
Practice Address - Street 1:370 S. CRENSHAW BLVD., STE. E106
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503
Practice Address - Country:US
Practice Address - Phone:310-503-6893
Practice Address - Fax:760-284-1542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-07
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251B00000XAgenciesCase Management
No385H00000XRespite Care FacilityRespite Care