Healthcare Provider Details

I. General information

NPI: 1407796832
Provider Name (Legal Business Name): MAGNIFICENT HOME HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2026
Last Update Date: 03/28/2026
Certification Date: 03/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7625 SUNRISE BLVD STE 214
CITRUS HEIGHTS CA
95610-2364
US

IV. Provider business mailing address

7625 SUNRISE BLVD STE 214
CITRUS HEIGHTS CA
95610-2364
US

V. Phone/Fax

Practice location:
  • Phone: 916-647-0438
  • Fax: 916-246-8185
Mailing address:
  • Phone: 916-647-0438
  • Fax: 916-246-8185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. MIRABELL S HALEY
Title or Position: CEO
Credential: HALEY
Phone: 510-945-9518