Healthcare Provider Details

I. General information

NPI: 1508301896
Provider Name (Legal Business Name): TRCA SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2016
Last Update Date: 12/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 MARK DR STE 33
SAN RAFAEL CA
94903-2268
US

IV. Provider business mailing address

77 MARK DR STE 33
SAN RAFAEL CA
94903-2268
US

V. Phone/Fax

Practice location:
  • Phone: 415-599-4333
  • Fax: 800-266-1834
Mailing address:
  • Phone: 415-599-4333
  • Fax: 800-266-1834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number214700009
License Number StateCA

VIII. Authorized Official

Name: LESLIE REESE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 415-599-4333