Provider Demographics
NPI:1699238782
Name:PRESERVE HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:PRESERVE HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EKE
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:KALU
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:925-998-1037
Mailing Address - Street 1:6007 TILLMAN CT
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-4765
Mailing Address - Country:US
Mailing Address - Phone:925-998-1037
Mailing Address - Fax:
Practice Address - Street 1:1633 ALUM ROCK AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-2430
Practice Address - Country:US
Practice Address - Phone:925-998-1037
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-07
Last Update Date:2019-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health