Organization
ON MY OWN INDEPENDENT LIVING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE RAMIREZ (CEO)
(916) 726-0792
Entity
Organization
Contact information
Practice address
6939 SUNRISE BLVD, SUITE 215, CITRUS HEIGHTS, CA 95610-3153
(916) 726-0792
Mailing address
6939 SUNRISE BLVD, SUITE 215, CITRUS HEIGHTS, CA 95610-3153
(916) 726-0792
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251G00000X
Community Based Hospice Care Agency
—
—
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2407772
COMPANY CORPORATION NUMBER
CA
01
—
347004697
RCFE CARE HOME LICENSE
CA
01
—
GEN-05336
CALIFORNIA BUSINESS LICENSE
CA
Enumeration date
10/25/2016
Last updated
10/25/2016
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