# CUSTOM CARE COMPANION

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CUSTOM CARE HOME HEALTH SERVICES INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1821410655
- **Legal business name:** CUSTOM CARE HOME HEALTH SERVICES INC
- **Authorized official:** MISS KIESHA CHARLTON (M)
- **Authorized official phone:** (916) 714-1155

## Contact information

- **Practice address:** 9826 BOND RD \# B, ELK GROVE, CA 95624-9419
- **Practice address phone:** (916) 704-3933
- **Practice address fax:** (916) 714-1165
- **Mailing address:** 2373 PO BOX, ELK GROVE, CA 95759
- **Mailing address phone:** (916) 714-1155
- **Mailing address fax:** (916) 714-1165

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 1400015060 | CA | Yes |

## Other

- **Enumeration date:** 01/14/2014
- **Last updated:** 01/14/2014