Provider Demographics
NPI:1962830380
Name:MANAGED CARE AT HOME INC
Entity type:Organization
Organization Name:MANAGED CARE AT HOME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BERNARDE
Authorized Official - Middle Name:MANGEBI
Authorized Official - Last Name:UDO
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:510-739-1992
Mailing Address - Street 1:830 HILLVIEW CT STE 225
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-4563
Mailing Address - Country:US
Mailing Address - Phone:510-739-1992
Mailing Address - Fax:510-952-4264
Practice Address - Street 1:830 HILLVIEW CT STE 225
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-4563
Practice Address - Country:US
Practice Address - Phone:510-739-1992
Practice Address - Fax:510-952-4264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-22
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health