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General NPI Number Information
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NPI Number | 1427755362
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Entity Type | Organization
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Legal Business Name | INDOCARE LLC
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Dates
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Enumeration Date | 02/10/2023
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Last Update Date | 02/10/2023
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Provider Practice Location Address
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Address Line | 8278 NEWFIELD CIR
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City | SACRAMENTO
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State | CA
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Zip | 95828-4915
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Country | US
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Telephone | 916-682-5461
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Fax |
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Provider Business Mailing Address
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Address Line | 10160 BRENNA WAY
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City | ELK GROVE
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State | CA
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Zip | 95757-5957
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Country | US
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Telephone | 916-647-3572
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Fax | 313-427-3662
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Authorized Official
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Title or Position | CEO
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Name | MR. PAUL LOMENDEHE
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Credential |
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Telephone | 915-596-5850
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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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