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Organization
PROFESSIONAL HEALTHCARE AT HOME LLC
Active
Organization
PROFESSIONAL HEALTHCARE AT HOME LLC
Active
Other names
CenterWell Home Health
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN NICHOLS (AUTHORIZED SIGNATORY)
(925) 246-6000
Entity
Organization
Contact information
Practice address
395 TAYLOR BLVD, SUITE 118, PLEASANT HILL, CA 94523-2286
(925) 246-6000
Mailing address
6330 SPRINT PKWY STE 300, OVERLAND PARK, KS 66211-1157
(913) 814-2674
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
020000449
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HHA07449F
MEDICAID
CA
Enumeration date
03/27/2006
Last updated
09/01/2022
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