Organization
YELLOWTAIL HOME CARE LLC
Active
Other names
Yellowtail Home Care
Organization subpart
No
Provider details
NPI number
Authorized official
YING LIU (ADMINISTRATOR)
(916) 868-4236
Entity
Organization
Contact information
Practice address
8513 YELLOWTAIL WAY, ANTELOPE, CA 95843-4951
(916) 868-4236
Mailing address
8161 CHIMANGO CT, ANTELOPE, CA 95843-5332
(916) 868-4236
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
342700766
DEPARTMENT OF SOCIAL SERVICES, CCLD
CA
Enumeration date
04/10/2023
Last updated
04/10/2023
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