Healthcare Provider Details

I. General information

NPI: 1972504702
Provider Name (Legal Business Name): SPECIALIZED DAYCARE SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 01/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8632 GREENBACK LN SUITE A
ORANGEVALE CA
95662-3913
US

IV. Provider business mailing address

PO BOX 1111
FAIR OAKS CA
95628-1111
US

V. Phone/Fax

Practice location:
  • Phone: 916-987-8632
  • Fax: 916-989-8635
Mailing address:
  • Phone: 916-987-8632
  • Fax: 916-989-8635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number100000763
License Number StateCA

VIII. Authorized Official

Name: MS. NANCY ANNE GIACHINO
Title or Position: PRESIDENT
Credential: RN
Phone: 916-987-8632