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General NPI Number Information
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NPI Number | 1629846779
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Entity Type | Organization
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Legal Business Name | NACILA, LLC
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Dates
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Enumeration Date | 12/18/2023
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Last Update Date | 02/20/2024
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Provider Practice Location Address
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Address Line | 2029 101ST AVE
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City | OAKLAND
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State | CA
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Zip | 94603-3353
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Country | US
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Telephone | 925-470-9078
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Fax |
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Provider Business Mailing Address
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Address Line | 348 CLARA ST
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City | OAKLAND
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State | CA
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Zip | 94603-1156
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Country | US
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Telephone | 678-851-9665
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NICOLE ROGERS
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Credential |
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Telephone | 678-851-9665
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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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