Basic Information
| Provider Information | |||||||||
| NPI: | 1023105392 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | WISH-I-AH CARE, INC. | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | |||||||||
| OtherOrganizationName: | WISH-I-AH CARE CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
| OtherLastName: | |||||||||
| OtherFirstName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 35680 WISH-I-AH ROAD | ||||||||
| Address2: | 35680 WISH-I-AH ROAD | ||||||||
| City: | AUBERRY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 936020615 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5598552211 | ||||||||
| FaxNumber: | 5598556590 | ||||||||
| Practice Location | |||||||||
| Address1: | 35680 WISH-I-AH ROAD | ||||||||
| Address2: | 35680 WISH-I-AH ROAD | ||||||||
| City: | AUBERRY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 936020615 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5598552211 | ||||||||
| FaxNumber: | 5598556590 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | HARSHMAN | ||||||||
| AuthorizedOfficialFirstName: | JANICE | ||||||||
| AuthorizedOfficialMiddleName: | MARIE | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 5598552211 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | CORPORATE PRESIDENT | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | CA | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.