Organization
CUSTOM CARE HOME HEALTH SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUDREY ACOSTA (OWNER/OPERATOR/ADMINISTRATOR)
(916) 714-1155
Entity
Organization
Contact information
Practice address
8837 ELK GROVE BLVD STE AANDB, ELK GROVE, CA 95624-1828
(916) 714-1155
(916) 714-1165
Mailing address
PO BOX 2792, ELK GROVE, CA 95759-2792
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003055195
—
CA
Enumeration date
10/08/2012
Last updated
01/09/2020
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