Healthcare Provider Details

I. General information

NPI: 1558279802
Provider Name (Legal Business Name): EBENEZ HOMECARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8260 MORNING STAR WAY
ELK GROVE CA
95757-5234
US

IV. Provider business mailing address

8260 MORNING STAR WAY
ELK GROVE CA
95757-5234
US

V. Phone/Fax

Practice location:
  • Phone: 916-204-4628
  • Fax:
Mailing address:
  • Phone: 916-204-4628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: IFEOMA CATHERINE OKEKE
Title or Position: ADMINISTRATOR
Credential:
Phone: 916-202-4995