ELICA HEALTH CENTERS (NPI# 1548705874) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1548705874 |
Entity Type | Organization |
Organization Name | ELICA HEALTH CENTERS |
Other Organization Name | ELICA HEALTH CENTERS - REVERE MEDICAL CENTER |
Practice Address |
752 Revere St Unit B Sacramento CA 95818-2073 |
Mailing Address |
1860 Howe Ave Ste 440 Sacramento CA 95825-1098 |
Practice Telephone | 8553542242 |
Practice Fax Number | 9168903828 |
Mailing Telephone | 9165698484 |
Mailing Fax Number | 9162562214 |
Enumeration Date | 2016-12-22 |
Last Update Date | 2019-08-14 |
Authorized Official Name | TATYANA BAK (CEO) |
Authorized Official Telephone | 9165698484 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | MEDICARE PART B | CB101A | 01 |
Other Name | Type Code |
---|---|
Elica Health Centers - Revere Medical Center | Other Name - Individual/Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265059182 | Elica Health Centers | Clinic/Center | 77 Cadillac Dr Ste 200, Sacramento, CA 95825-8337 | 2020-06-26 |
1740660703 | Elica Health Centers | Clinic/Center | 1750 Wright St Ste 1, Sacramento, CA 95825-4041 | 2015-06-04 |
1548425853 | Elica Health Centers | Clinic/Center | 155 15th St Ste A, West Sacramento, CA 95691-3737 | 2008-07-25 |
1366051120 | Elica Health Centers | Clinic/Center | 4815 Watt Ave, North Highlands, CA 95660-5108 | 2020-07-28 |
1366068553 | Elica Health Centers | Clinic/Center | 1276 Halyard Dr, West Sacramento, CA 95691-3412 | 2020-06-23 |
1154947711 | Elica Health Centers | Clinic/Center | 6339 Mack Rd, Sacramento, CA 95823-4655 | 2020-06-19 |
1760013494 | Elica Health Centers | Clinic/Center | 1276 Halyard Dr, West Sacramento, CA 95691-3412 | 2020-01-31 |
1851893077 | Elica Health Centers | Clinic/Center | 5708 Watt Avenue, North Highlands, CA 95660 | 2018-03-03 |
1205341336 | Elica Health Centers | Clinic/Center | 1276 Halyard Dr, West Sacramento, CA 95691-3412 | 2017-12-12 |
1730693805 | Elica Health Centers | Clinic/Center | 1276 Halyard Dr, West Sacramento, CA 95691-3412 | 2017-11-27 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | ELICA HEALTH CENTERS | 155 15th St, West Sacramento, CA 95691-3737 |
Street Address |
752 REVERE ST UNIT B |
City | SACRAMENTO |
State | CA |
Zip Code | 95818-2073 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780206557 | Ten Acres Pharmacy | Pharmacy | 2930 Freeport Blvd, Sacramento, CA 95818 | 2020-05-14 |
1467928200 | Safeway Inc | Durable Medical Equipment & Medical Supplies | 3680 Crocker Dr, Ste 100, Sacramento, CA 95818 | 2018-10-19 |
1295254084 | Family Business Ventures LLC | In Home Supportive Care | 2026 X Street, Sacramento, CA 95818 | 2017-09-13 |
1932656550 | Roshelle Chan | Student in an Organized Health Care Education/Training Program | 1964 36th Street, Sacramento, CA 95818 | 2016-09-01 |
1144692724 | Ivyridge Assisted Living | Assisted Living Facility | 2030 23 Rd Street, Sacramento, CA 95818 | 2015-10-22 |
1255672788 | Kimberly Ann Delaney | Speech-Language Pathologist | 2741 Riverside Blvd Ste 2, Sacramento, CA 95818 | 2013-03-07 |
1285985473 | Salatha Helton | Marriage & Family Therapist | 3067 Freeport Blvd Ste 8, Sacramento, CA 95818 | 2012-09-27 |
1508976382 | Victoria M Sarantopulos | Marriage & Family Therapist | 2015 21st St Suite 304, Sacramento, CA 95818 | 2006-08-30 |
1871986638 | Connected Speech Therapy, Inc. | Speech-Language Pathologist | 2741 Riverside Blvd Ste 2, Sacramento, CA 95818 | 2015-03-18 |
1851640965 | Chris Arbabian | Chiropractor | 2716 V Street, Sacramento, CA 95818 | 2012-09-05 |
Find all providers in zip 95818 |
Taxonomy Code | 261QF0400X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Federally Qualified Health Center (FQHC) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265059182 | Elica Health Centers | Clinic/Center | 77 Cadillac Dr Ste 200, Sacramento, CA 95825-8337 | 2020-06-26 |
1508487653 | Health and Life Organization, Inc. (h.a.l.o.) | Clinic/Center | 7215 55th St Ste B, Sacramento, CA 95823-2601 | 2020-04-29 |
1720546724 | Wellspace Health | Clinic/Center | 4241 Florin Rd Ste 30, Sacramento, CA 95823-2535 | 2019-03-08 |
1073077616 | Cares Community Health | Clinic/Center | 815 S St, Sacramento, CA 95811-7064 | 2019-01-28 |
1982114492 | Cares Community Health | Clinic/Center | 1442 Ethan Way Ste 100, Sacramento, CA 95825-2232 | 2017-10-10 |
1063965952 | Health for All - Revere Clinic | Clinic/Center | 752 Revere St, Unit B, Sacramento, CA 95818-2073 | 2016-07-27 |
1164886040 | Peach Tree Healthcare | Clinic/Center | 3810 Rosin Ct, Suite 100, Sacramento, CA 95834-1656 | 2016-04-07 |
1740660703 | Elica Health Centers | Clinic/Center | 1750 Wright St Ste 1, Sacramento, CA 95825-4041 | 2015-06-04 |
1104210608 | Wellspace Health | Clinic/Center | 3535 65th St, Suite C, Sacramento, CA 95820-2057 | 2015-03-23 |
1508284407 | Health for All - Administration | Clinic/Center | 420 I Street, Suite 7, Sacramento, CA 95814-2319 | 2014-03-29 |
Find all providers in SACRAMENTO |
City | SACRAMENTO |
Zip Code | 95818 |
Please comment or provide details below to improve the information on ELICA HEALTH CENTERS.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.