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General NPI Number Information
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NPI Number | 1144710559
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Entity Type | Organization
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Legal Business Name | G&A CANTILLER INC
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Dates
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Enumeration Date | 05/11/2018
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Last Update Date | 05/11/2018
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Provider Practice Location Address
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Address Line | 8006 BUCKS HARBOR WAY
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City | SACRAMENTO
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State | CA
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Zip | 95828-5435
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Country | US
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Telephone | 916-689-5491
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Fax | 916-627-1307
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Provider Business Mailing Address
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Address Line | 9616 RICHLYN WAY
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City | ELK GROVE
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State | CA
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Zip | 95757-4034
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Country | US
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Telephone | 916-803-0815
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. ARACELI A CANTILLER
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Credential |
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Telephone | 916-803-0815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number |
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License Number State |
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