Healthcare Provider Details

I. General information

NPI: 1710918644
Provider Name (Legal Business Name): TOP CARE REHAB INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 12/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4813 TEGAN RD
ELK GROVE CA
95758-5149
US

IV. Provider business mailing address

PO BOX 582138
ELK GROVE CA
95758-0036
US

V. Phone/Fax

Practice location:
  • Phone: 916-427-5613
  • Fax: 916-427-5641
Mailing address:
  • Phone: 916-427-5613
  • Fax: 916-427-5641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number080-0004266
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number08-00004266
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number08-000042666
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number08-00004266
License Number StateCA

VIII. Authorized Official

Name: MRS. SHIVETTI BEATRICE OSSOME
Title or Position: CEO
Credential: MS
Phone: 916-427-5613