PROVIDENCE HOME HEALTH HUMBOLDT is a certified and licensed healthcare facility located in 2127 HARRISON AVE., EUREKA, CA, 95501. The California Department of Public Health facility license number is 010000057. The facility started participation in Center for Medicare and Medicaid Services (CMS) in 1980-12-12 and its participation was approved in 2017-06-20.
The type of facility is HOME HEALTH AGENCY. It . The facility administrator is GLOVER, MICHELE.
| License Number | 010000057 |
| License Status | ACTIVE |
| License Effective Date | 2023-11-01 00:00:00 |
| License Expiration Date | 2024-10-31 00:00:00 |
| National Provider Identifier (NPI) | 1144315052 |
| CCN (CMS Certification Number) | 057256 |
| Entity Type | NONPROFIT CORP |
| T18 / T19 | |
| Facility Type | HOME HEALTH AGENCY |
| Critical Access Hospital facility | No |
| Birthing Facility | |
| Approval Date | 2017-06-20 00:00:00 |
| Parent Facility | |
| Type of Care |
| Facility Administrtor | |
| MICHELE.GLOVER@STJOE.ORG | |
| Street Address | 2127 HARRISON AVE. |
| City | EUREKA |
| State | California |
| ZIP | 95501 |
| Phone | (610) 844-3224 |
| Fax | (707) 443-8142 |
The California Department of Public Health (CDPH), Center for Health Care Quality, Licensing and Certification (L&C) Program licenses and certifies more than 30 types of healthcare facilities. You can search California healthcare facilities that are operational and have a current license issued by the CDPH and/or a current U.S. Department of Health and Human Services’ Centers for Medicare and Medicaid Services (CMS) certification.
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