Healthcare Provider Details

I. General information

NPI: 1255242731
Provider Name (Legal Business Name): CAPITAL SENIOR CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7005 WAVECREST WAY
SACRAMENTO CA
95831-2523
US

IV. Provider business mailing address

4453 SOPHISTRY DR
RANCHO CORDOVA CA
95742-8073
US

V. Phone/Fax

Practice location:
  • Phone: 916-812-0944
  • Fax: 916-266-9391
Mailing address:
  • Phone: 916-812-0944
  • Fax: 916-266-9391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: EDGAR ENERO
Title or Position: CEO
Credential:
Phone: 916-812-0944