Healthcare Provider Details

I. General information

NPI: 1730978487
Provider Name (Legal Business Name): T AND V ROOMING FOR THE MENTALLY AND DISABLE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2025
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3928 44TH AVE
SACRAMENTO CA
95824-3576
US

IV. Provider business mailing address

1256 RINGLET AVE UNIT 101
SACRAMENTO CA
95811-0468
US

V. Phone/Fax

Practice location:
  • Phone: 916-336-3299
  • Fax:
Mailing address:
  • Phone: 279-666-8410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: VERONICA WELLS
Title or Position: OWNER
Credential: EWOSB, SB, PW , CAS
Phone: 279-666-8410