Healthcare Provider Details

I. General information

NPI: 1932645645
Provider Name (Legal Business Name): SACRAMENTO BASED ADULT DAY SERVICE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2017
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 BERCUT DR
SACRAMENTO CA
95811-0131
US

IV. Provider business mailing address

620 BERCUT DR
SACRAMENTO CA
95811-0131
US

V. Phone/Fax

Practice location:
  • Phone: 916-444-7700
  • Fax: 916-444-7794
Mailing address:
  • Phone: 916-440-7700
  • Fax: 916-444-7794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA THERESA SUNDBERG
Title or Position: CONSULTANT
Credential: MHCA
Phone: 619-414-4530