Healthcare Provider Details

I. General information

NPI: 1255294468
Provider Name (Legal Business Name): HILL SUPPORTED LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2251 FLORIN RD. SUITE 96
SACRAMENTO CA
95822
US

IV. Provider business mailing address

9146 E STOCKTON BLVD # 1166
ELK GROVE CA
95624-9510
US

V. Phone/Fax

Practice location:
  • Phone: 279-333-5182
  • Fax:
Mailing address:
  • Phone: 279-333-5182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLYN HILL
Title or Position: CEO
Credential:
Phone: 279-333-5182