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General NPI Number Information
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NPI Number | 1639330616
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Entity Type | Organization
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Legal Business Name | SACRAMENTO CHOICE REHABILITATION PROGRAM
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Dates
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Enumeration Date | 06/22/2008
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Last Update Date | 07/10/2009
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Provider Practice Location Address
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Address Line | 5524 ASSEMBLY COURT STE #45
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City | SACRAMENTO
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State | CA
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Zip | 95823-2625
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Country | US
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Telephone | 916-425-4300
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Fax | 916-391-1218
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Provider Business Mailing Address
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Address Line | 5524 ASSEMBLY COURT STE #45
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City | SACRAMENTO
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State | CA
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Zip | 95823-2625
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Country | US
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Telephone | 916-425-4300
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Fax | 916-391-1218
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Authorized Official
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Title or Position | BOARD CHAIRPERSON
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Name | MR. FELIX OLORUNMO ABU
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Credential | MS
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Telephone | 916-425-4300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | CA
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