CUSTOMCARE HOME HEALTH SERVICES (NPI# 1720120330) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720120330 |
| Entity Type | Organization |
| Organization Name | CUSTOMCARE HOME HEALTH SERVICES |
| Practice Address |
5524 Assmbly Court 58 Sacramento CA 95823 |
| Mailing Address |
5524 Assembly Ct Ste 58 Sacramento CA 95823-2606 |
| Practice Telephone | 9164227327 |
| Practice Fax Number | 9164227303 |
| Mailing Telephone | 9164227327 |
| Mailing Fax Number | 9164227303 |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | KIESHA CHARLTON (BILLING MANAGER) |
| Authorized Official Telephone | 9164227327 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3140N1450X |
Skilled Nursing Facility Specialization: Nursing Care, Pediatric |
315193 | CA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | HOME HEALTH | HHA57540F | 01 |
| Street Address |
5524 ASSMBLY COURT 58 |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95823 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396343422 | Renee Yvonne Friesner | Registered Nurse | 6965 65th Street, Sacramento, CA 95823 | 2020-10-12 |
| 1790392165 | Amanda Moore | Technician | 6445 Village Center Dr, Building 7 Apt 101, Sacramento, CA 95823 | 2020-09-29 |
| 1114562766 | Daniel & Max, LLC | Optometrist | 4200 Florin Road, Suite C, Florin, CA 95823 | 2019-11-07 |
| 1396393823 | Lannon Hope Gustafson | Counselor | 8573 E Southgate Dr., Sacramento, CA 95823 | 2019-08-28 |
| 1932768280 | Sprenger Behavioral Medicine, Inc | Psychiatry & Neurology | 7601 Hospital Drive Suite 202, Suite 202, Sacramento, CA 95823 | 2019-06-11 |
| 1306316880 | Evin Johnson | Case Manager/Care Coordinator | 7000 Franklin Blvd Suite 625, Sacramento, CA 95823 | 2018-11-28 |
| 1902373095 | Alexandra L Bourcy | Family Medicine | 7275 E Southgate Dr Ste 204-206, Sacramento, CA 95823 | 2018-10-27 |
| 1891298923 | Nicholas Joseph Henderson | Behavior Technician | 6500 47th Street Apt#76, Sacramento, CA 95823 | 2018-03-15 |
| 1427567098 | Luz Maria Udave | Behavior Technician | 5435 Mack Rd Apt 87, Sacramento, CA 95823 | 2017-09-26 |
| 1417474743 | Elizabeth Smithers | Behavior Technician | 5545 Sky Parkway #202, Sacramento, CA 95823 | 2017-08-28 |
| Find all providers in zip 95823 | ||||
| Taxonomy Code | 3140N1450X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| Specialization | Nursing Care, Pediatric |
| A nursing care facility designed and staffed for the provision of nursing care and appropriate educational and habilitative/rehabilitative services to children with multiple, complex or profound disabilities that can not be cared for in a less restrictive environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437312055 | Kitty's | Skilled Nursing Facility | 7655 Laurie Way, 7655 Laurie Way, Sacramento, CA 95832-1514 | 2008-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700499746 | Crosspeaks Services, Inc. | Skilled Nursing Facility | 4165 Brittany Dr, Redding, CA 96002-5102 | 2020-08-28 |
| 1023551264 | Eden Care Center | Skilled Nursing Facility | 7616 Pacific Blvd, Huntington Park, CA 90255-6026 | 2016-11-21 |
| 1740736198 | Corwin Kids Healthcare Inc | Skilled Nursing Facility | 18747 Corwin Rd, Apple Valley, CA 92307-2303 | 2016-08-26 |
| 1073914412 | Crosspeaks Services, Inc. | Skilled Nursing Facility | 1350 Teal Hollow Dr, Yuba City, CA 95993-8885 | 2014-09-04 |
| 1669886230 | Centennial Healthcare LLC | Skilled Nursing Facility | 7504 Capps Ave, Reseda, CA 91335-2710 | 2014-06-11 |
| 1851660682 | George Nobuhiko Tobo | Skilled Nursing Facility | 16423 Harbor Blvd, Fountain Valley, CA 92708-1367 | 2011-12-22 |
| 1427348424 | Bridge 2 Life Healthcare, Inc. | Skilled Nursing Facility | 1331 Addison Way, Perris, CA 92571-3878 | 2011-04-11 |
| 1033417167 | Wee Hearts | Skilled Nursing Facility | 10049 Magnolia Blvd, 539, N Hollywood, CA 91606 | 2011-03-15 |
| 1720300783 | Kidz Kingdom Pdhc | Skilled Nursing Facility | 13022 Sherman Way, North Hollywood, CA 91605-4955 | 2010-02-18 |
| 1285884411 | Twins Services and Training Center | Skilled Nursing Facility | 22910 Teil Glen Rd, Wildomar, CA 92595-8099 | 2008-09-24 |
| Find all providers with the same taxonomy | ||||
| City | SACRAMENTO |
| Zip Code | 95823 |
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| 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.