Provider Demographics
NPI:1699090696
Name:PROFESSIONAL IN HOME CARE, INC
Entity type:Organization
Organization Name:PROFESSIONAL IN HOME CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHNABEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-777-9002
Mailing Address - Street 1:24307 MAGIC MOUNTAIN PKWY
Mailing Address - Street 2:#136
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-3402
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1431 W ROSAMOND BLVD
Practice Address - Street 2:#15D
Practice Address - City:ROSAMOND
Practice Address - State:CA
Practice Address - Zip Code:93560-7428
Practice Address - Country:US
Practice Address - Phone:661-777-9002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-01
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA253Z00000X, 385HR2060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child