At Home Support Senior Care, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

AT HOME SUPPORT SENIOR CARE, LLC

Practice address

715 El Camino Real Ste 205
San Bruno, CA 94066-3439

Phone

(650) 585-4447

Fax

(650) 989-4480

NPI assigned

Apr 9, 2012

Last updated

May 15, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. J Justin Tuvilla

Title

Owner

Phone

(650) 270-0574

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1333929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589500800000",
    "number": "1013273515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 EL CAMINO REAL STE 205",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940663439",
            "telephone_number": "650-585-4447",
            "fax_number": "650-989-4480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 EL CAMINO REAL STE 205",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940663439",
            "telephone_number": "650-585-4447",
            "fax_number": "650-989-4480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 Crystal Springs Rd",
            "address_2": "#215",
            "address_purpose": "LOCATION",
            "city": "San Bruno",
            "state": "CA",
            "postal_code": "940664638",
            "country_code": "US",
            "telephone_number": "650-585-4447",
            "fax_number": "650-989-4480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AT HOME SUPPORT SENIOR CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-09",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A",
        "authorized_official_last_name": "TUVILLA",
        "authorized_official_first_name": "J JUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "650-270-0574",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in San Bruno, CA
• Providers in San Bruno, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.