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General NPI Number Information
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NPI Number | 1689769556
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Entity Type | Organization
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Legal Business Name | EL DORADO COUNTY MULTI-PURPOSE SENIOR SERVICES PROGRAM
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 937 SPRING ST
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City | PLACERVILLE
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State | CA
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Zip | 95667-4543
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Country | US
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Telephone | 530-621-6155
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Fax | 530-295-8307
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Provider Business Mailing Address
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Address Line | 937 SPRING ST
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City | PLACERVILLE
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State | CA
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Zip | 95667-4543
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Country | US
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Telephone | 530-621-6155
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Fax | 530-295-8307
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. JOHN LITWINOVICH
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Credential |
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Telephone | 530-621-6163
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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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