Healthcare Provider Details

I. General information

NPI: 1982114492
Provider Name (Legal Business Name): CARES COMMUNITY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2017
Last Update Date: 03/30/2022
Certification Date: 03/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1442 ETHAN WAY STE 100
SACRAMENTO CA
95825-2232
US

IV. Provider business mailing address

1500 21ST ST
SACRAMENTO CA
95811-5216
US

V. Phone/Fax

Practice location:
  • Phone: 916-443-3299
  • Fax:
Mailing address:
  • Phone: 916-443-3299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateCA

VIII. Authorized Official

Name: MICHELLE MONROE
Title or Position: CEO
Credential:
Phone: 916-914-6240