Healthcare Provider Details

I. General information

NPI: 1104464163
Provider Name (Legal Business Name): ARVEAH'S CARE HOMES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2019
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10620 OAK POND LN
ELK GROVE CA
95624-9342
US

IV. Provider business mailing address

10620 OAK POND LN
ELK GROVE CA
95624-9342
US

V. Phone/Fax

Practice location:
  • Phone: 530-662-6055
  • Fax: 530-662-6055
Mailing address:
  • Phone: 530-662-6055
  • Fax: 530-662-6055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: LEAH MARTINEZ-DAVIS
Title or Position: MANAGER
Credential: MSN, RN, CSCM
Phone: 650-466-6899