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General NPI Number Information
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NPI Number | 1508959214
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Entity Type | Organization
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Legal Business Name | JDL HEALTHCARE INC
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2257 FAIR OAKS BLVD
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City | SACRAMENTO
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State | CA
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Zip | 95825-5501
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Country | US
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Telephone | 916-649-2000
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Fax | 916-649-2244
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Provider Business Mailing Address
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Address Line | 2257 FAIR OAKS BLVD
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City | SACRAMENTO
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State | CA
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Zip | 95825-5501
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Country | US
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Telephone | 916-649-2000
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Fax | 916-649-2244
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. STEPHEN CROOKS FIFE
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Credential |
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Telephone | 916-649-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State | CA
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