Healthcare Provider Details

I. General information

NPI: 1487570701
Provider Name (Legal Business Name): GRISWOLD HOME CARE FOR ROSEVILLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5875 PACIFIC ST STE B1
ROCKLIN CA
95677-3146
US

IV. Provider business mailing address

5875 PACIFIC ST STE B1
ROCKLIN CA
95677-3146
US

V. Phone/Fax

Practice location:
  • Phone: 916-251-7420
  • Fax:
Mailing address:
  • Phone: 916-251-7420
  • 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: ANTONIO DE LA CRUZ
Title or Position: OWNER/MANAGING MEMBER
Credential:
Phone: 916-293-2541