Healthcare Provider Details

I. General information

NPI: 1902218472
Provider Name (Legal Business Name): CAREFREE ASSISTED LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2014
Last Update Date: 06/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5490 ENRICO BLVD
SACRAMENTO CA
95820-6438
US

IV. Provider business mailing address

5490 ENRICO BLVD
SACRAMENTO CA
95820-6438
US

V. Phone/Fax

Practice location:
  • Phone: 916-224-7537
  • Fax:
Mailing address:
  • Phone: 916-224-7537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number347005281
License Number StateCA

VIII. Authorized Official

Name: MR. MARK J CIMINO
Title or Position: CEO
Credential:
Phone: 916-468-9639