Healthcare Provider Details

I. General information

NPI: 1720918683
Provider Name (Legal Business Name): HOUSING ROOMMATES SUCCESS FOUNDATION INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3830 WATT AVE STE 3
SACRAMENTO CA
95821-2669
US

IV. Provider business mailing address

3830 WATT AVE STE 3
SACRAMENTO CA
95821-2669
US

V. Phone/Fax

Practice location:
  • Phone: 916-862-8836
  • Fax:
Mailing address:
  • Phone: 916-862-8836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: MS. CAROLYN TEVIS
Title or Position: CEO
Credential:
Phone: 916-862-8836