Organization
INTERACTIVE CARE AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELVIN JOHNSON (OWNER)
(408) 239-9261
Entity
Organization
Contact information
Practice address
2050 SOUTHWEST EXPY APT 72, SAN JOSE, CA 95126-4641
(408) 239-9261
Mailing address
2050 SOUTHWEST EXPY APT 72, SAN JOSE, CA 95126-4641
(408) 239-9261
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
7466955655
CA
251G00000X
Community Based Hospice Care Agency
7466955655
CA
253Z00000X
In Home Supportive Care Agency
Primary
7466955655
CA
Other
Enumeration date
08/09/2010
Last updated
03/30/2011
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