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Organization
MACKELLAH HOME
Active
Organization
MACKELLAH HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NELSON SANTOS JACINTO (OWNER)
(916) 725-6348
Entity
Organization
Contact information
Practice address
6813 MARINVALE DR, CITRUS HEIGHTS, CA 95621-1937
(916) 725-6348
Mailing address
6813 MARINVALE DR, CITRUS HEIGHTS, CA 95621-1937
(916) 725-6348
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
347000955
CA
Other
Enumeration date
10/15/2006
Last updated
07/08/2008
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