Organization
CASADEMCKENZIEHOMECARESERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILMA SERVANDO COX (COO)
(408) 750-7904
Entity
Organization
Contact information
Practice address
1361 SNYDER AVE, MODESTO, CA 95356-8901
(408) 750-7904
(209) 408-8066
Mailing address
1361 SNYDER AVE, MODESTO, CA 95356-8901
(408) 750-7904
(209) 408-8066
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000001
VETERANS/CONSERVATORSHIP
CA
Enumeration date
07/11/2020
Last updated
07/11/2020
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