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General NPI Number Information
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NPI Number | 1396466306
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Entity Type | Organization
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Legal Business Name | MINDSTAR SERVICES
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Dates
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Enumeration Date | 09/07/2022
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Last Update Date | 11/28/2023
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Provider Practice Location Address
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Address Line | 180 PROMENADE CIR STE 300
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City | SACRAMENTO
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State | CA
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Zip | 95834-2952
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Country | US
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Telephone | 916-903-2538
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Fax | 916-634-7701
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Provider Business Mailing Address
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Address Line | 180 PROMENADE CIR STE 300
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City | SACRAMENTO
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State | CA
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Zip | 95834-2952
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Country | US
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Telephone | 916-903-2538
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Fax | 916-634-7701
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. TERRELL GRANT
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Credential |
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Telephone | 530-902-6336
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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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Taxonomy #2
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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