Healthcare Provider Details

I. General information

NPI: 1215864848
Provider Name (Legal Business Name): LIRICARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1175 NIMITZ AVENUE SUITE #180
VALLEJO CA
94592
US

IV. Provider business mailing address

16192 COASTAL HIGHWAY LEWES, DELAWARE 19958
LEWES DE
19958
US

V. Phone/Fax

Practice location:
  • Phone: 408-833-9633
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ANU UPADHYAYA
Title or Position: DIRECTOR OF SCHOOL SERVICES
Credential:
Phone: 804-441-3874