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Organization

IN HOME HEALTH LLC

Active
Other names
ProMedica Hospice (San Rafael), ProMedica Hospice (Santa Rosa)
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MARTIN D ALLEN (DIRECTOR)
(419) 252-5734
Entity
Organization

Contact information

Practice address
3700 OLD REDWOOD HWY STE 103, SANTA ROSA, CA 95403-5740
(707) 523-0111
(707) 523-1034
Mailing address
333 N SUMMIT ST, ATTN: DEAN SHIPMAN, TOLEDO, OH 43604
(419) 254-7841
(419) 252-6448

Taxonomy

Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
251G00000X
Community Based Hospice Care Agency
Primary
100000738
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
HPC-01696F
CA
Enumeration date
05/16/2006
Last updated
04/15/2022
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