Organization
EASTERN PLUMAS HEALTH CARE HOME HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JERILEE NELSON CPA (CFO)
(530) 832-6578
Entity
Organization
Contact information
Practice address
500 1ST AVE, PORTOLA, CA 96122-9406
(530) 832-6500
Mailing address
500 1ST AVE, PORTOLA, CA 96122-9406
(530) 832-6500
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
057727
CA
251E00000X
Home Health Agency
230000014
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HHA07727F
—
CA
01
—
ZZZ45177Z
BLUE SHIELD HOME HEALTH
CA
Enumeration date
06/27/2005
Last updated
12/10/2013
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