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General NPI Number Information
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NPI Number | 1053501734
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Entity Type | Organization
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Legal Business Name | SS&MC
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Dates
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Enumeration Date | 07/27/2007
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Last Update Date | 03/10/2008
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Provider Practice Location Address
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Address Line | 216 N EAST ST SUITE 101
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City | WOODLAND
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State | CA
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Zip | 95776-5904
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Country | US
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Telephone | 916-769-0148
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Fax | 916-290-0335
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Provider Business Mailing Address
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Address Line | 3270 ARENA BLVD SUITE 400-101
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City | SACRAMENTO
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State | CA
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Zip | 95834-3001
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Country | US
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Telephone | 916-769-0148
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Fax | 916-290-0335
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. SUKHRAJ KAUR MANN
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Credential | REGISTERED NURSE
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Telephone | 916-769-0148
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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