Organization
CUSTOMCARE HOME HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIESHA CHARLTON (BILLING MANAGER)
(916) 422-7327
Entity
Organization
Contact information
Practice address
5524 ASSMBLY COURT 58, SACRAMENTO, CA 95823
(916) 422-7327
(916) 422-7303
Mailing address
5524 ASSEMBLY CT STE 58, SACRAMENTO, CA 95823-2606
(916) 422-7327
(916) 422-7303
Taxonomy
Speciality
Code
Description
License number
State
3140N1450X
Pediatric Skilled Nursing Facility
Primary
315193
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HHA57540F
HOME HEALTH
CA
Enumeration date
02/12/2007
Last updated
08/22/2020
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