Healthcare Provider Details

I. General information

NPI: 1245937861
Provider Name (Legal Business Name): VACAVILLE SOLANO SERVICES CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2023
Last Update Date: 02/14/2023
Certification Date: 02/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

267 BENNETT HILL CT
VACAVILLE CA
95688-2906
US

IV. Provider business mailing address

267 BENNETT HILL CT
VACAVILLE CA
95688-2906
US

V. Phone/Fax

Practice location:
  • Phone: 707-447-1988
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State

VIII. Authorized Official

Name: COLLEEN BERUMEN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 707-447-1988