Provider Demographics
NPI:1720309891
Name:SANDERS HOMECARE INC.
Entity type:Organization
Organization Name:SANDERS HOMECARE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PAULINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:510-352-6900
Mailing Address - Street 1:400 ESTUDILLO AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-4999
Mailing Address - Country:US
Mailing Address - Phone:510-352-6900
Mailing Address - Fax:510-352-3900
Practice Address - Street 1:400 ESTUDILLO AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-4999
Practice Address - Country:US
Practice Address - Phone:510-352-6900
Practice Address - Fax:510-352-3900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-11
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN LICENSE # 287632253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care