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General NPI Number Information
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NPI Number | 1346022621
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Entity Type | Organization
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Legal Business Name | RAPHA EXPRESS
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Dates
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Enumeration Date | 10/20/2023
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Last Update Date | 10/20/2023
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Provider Practice Location Address
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Address Line | 5366 KANKAKEE DR
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City | SACRAMENTO
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State | CA
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Zip | 95835-3058
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Country | US
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Telephone | 916-248-1026
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Fax | 916-543-1831
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Provider Business Mailing Address
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Address Line | 5366 KANKAKEE DR
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City | SACRAMENTO
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State | CA
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Zip | 95835-3058
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Country | US
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Telephone | 916-248-1026
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ATIEN MARIUS KOUASSI
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Credential | CSCM
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Telephone | 916-248-1026
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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