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General NPI Number Information
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NPI Number | 1508301896
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Entity Type | Organization
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Legal Business Name | TRCA SERVICES LLC
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Dates
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Enumeration Date | 12/22/2016
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Last Update Date | 12/22/2016
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Provider Practice Location Address
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Address Line | 77 MARK DR STE 33
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City | SAN RAFAEL
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State | CA
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Zip | 94903-2268
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Country | US
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Telephone | 415-599-4333
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Fax | 800-266-1834
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Provider Business Mailing Address
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Address Line | 77 MARK DR STE 33
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City | SAN RAFAEL
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State | CA
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Zip | 94903-2268
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Country | US
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Telephone | 415-599-4333
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Fax | 800-266-1834
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | LESLIE REESE
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Credential |
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Telephone | 415-599-4333
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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 | 214700009
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License Number State | CA
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