Healthcare Provider Details

I. General information

NPI: 1144970088
Provider Name (Legal Business Name): REBUILDING TOGETHER SACRAMENTO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2022
Last Update Date: 08/01/2022
Certification Date: 07/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8231 ALPINE AVE STE 3
SACRAMENTO CA
95826-4746
US

IV. Provider business mailing address

PO BOX 255584
SACRAMENTO CA
95865-5584
US

V. Phone/Fax

Practice location:
  • Phone: 916-455-1880
  • Fax: 916-731-7077
Mailing address:
  • Phone: 916-455-1880
  • Fax: 916-731-7077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name: CARRIE LOUISE GRIP
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 916-455-1880