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NPI 1336096338

NPI 1336096338 : AUNT DOTTIES PLACE : ROSEVILLE, CA

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General NPI Number Information
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    NPI Number           |    1336096338
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    Entity Type          |    Organization 
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    Legal Business Name  |    AUNT DOTTIES PLACE 
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Dates
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    Enumeration Date     |    03/11/2026
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    Last Update Date     |    03/11/2026
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Provider Practice Location Address
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    Address Line         |    224 SAGEMOOR CT 
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    City                 |    ROSEVILLE
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    State                |    CA
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    Zip                  |    95678-3435
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    Country              |    US
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    Telephone            |    916-790-4124
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    Fax                  |    916-540-7610
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Provider Business Mailing Address
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    Address Line         |    224 SAGEMOOR CT 
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    City                 |    ROSEVILLE
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    State                |    CA
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    Zip                  |    95678-3435
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    Country              |    US
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    Telephone            |    916-790-4124
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    Fax                  |    916-540-7610
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |    MR. ABRAHAM  TEWELDEBRHAN 
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    Credential           |    
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    Telephone            |    510-689-6059
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    310400000X
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    Taxonomy Name        |    Assisted Living Facility
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    License Number       |    
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    License Number State |    
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