Healthcare Provider Details

I. General information

NPI: 1205730876
Provider Name (Legal Business Name): KIRABO CARE HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4911 KENNETH AVE
CARMICHAEL CA
95608-4260
US

IV. Provider business mailing address

4911 KENNETH AVE
CARMICHAEL CA
95608-4260
US

V. Phone/Fax

Practice location:
  • Phone: 916-470-4060
  • Fax:
Mailing address:
  • Phone: 916-470-4060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3104A0630X
TaxonomyAssisted Living Facility (Behavioral Disturbances)
License Number
License Number StateNULL

VIII. Authorized Official

Name: ERIAM SOLOME NNAMALIRI
Title or Position: OWNER
Credential: NP
Phone: 916-470-4060