Healthcare Provider Details

I. General information

NPI: 1265023915
Provider Name (Legal Business Name): MSK SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2021
Last Update Date: 01/26/2021
Certification Date: 01/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1116 LEGEND CIR
VALLEJO CA
94591-8679
US

IV. Provider business mailing address

3871 QUARRYVILLE CT
FAIRFIELD CA
94533-6651
US

V. Phone/Fax

Practice location:
  • Phone: 707-647-3972
  • Fax:
Mailing address:
  • Phone: 510-681-7988
  • Fax: 510-323-8066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. TEGRE MILES
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 510-681-7988