Provider Demographics
NPI:1356809594
Name:ISELEN BUSINESS ENTERPRISE, INC
Entity type:Organization
Organization Name:ISELEN BUSINESS ENTERPRISE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONKE
Authorized Official - Middle Name:
Authorized Official - Last Name:ISELEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-690-9612
Mailing Address - Street 1:3137 CASTRO VALLEY BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-5552
Mailing Address - Country:US
Mailing Address - Phone:510-690-9612
Mailing Address - Fax:510-690-9652
Practice Address - Street 1:3137 CASTRO VALLEY BLVD STE 201
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-5552
Practice Address - Country:US
Practice Address - Phone:510-690-9612
Practice Address - Fax:510-690-9652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA253Z00000XOtherIN HOME SUPPORTIVE CARE