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General NPI Number Information
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NPI Number | 1760067961
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Entity Type | Organization
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Legal Business Name | VALINE SENIOR CARE
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Dates
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Enumeration Date | 03/10/2021
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Last Update Date | 03/10/2021
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Provider Practice Location Address
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Address Line | 966 43RD AVENUE
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City | SACRAMENTO
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State | CA
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Zip | 95831
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Country | US
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Telephone | 916-694-9400
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Fax | 916-394-9405
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Provider Business Mailing Address
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Address Line | P.O. BOX 7914
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City | STOCKTON
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State | CA
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Zip | 95267
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Country | US
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Telephone | 209-956-5633
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Fax | 916-471-0401
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. PAUL B CIMINO
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Credential |
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Telephone | 916-606-8677
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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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