Healthcare Provider Details

I. General information

NPI: 1932861192
Provider Name (Legal Business Name): SACRAMENTO SELF HELP HOUSING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2021
Last Update Date: 10/06/2021
Certification Date: 10/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 HURLEY WAY STE 500
SACRAMENTO CA
95825-3216
US

IV. Provider business mailing address

1010 HURLEY WAY, #500 FINANCE DEPARTMENT
SACRAMENTO CA
95825
US

V. Phone/Fax

Practice location:
  • Phone: 916-341-0593
  • Fax:
Mailing address:
  • Phone: 916-341-0593
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. CECILIA MIN
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 916-479-0396