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General NPI Number Information
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NPI Number | 1790408276
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Entity Type | Organization
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Legal Business Name | BOLA HOME HEALTH AGENCY LLC
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Dates
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Enumeration Date | 09/20/2022
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 7275 E SOUTHGATE DR STE 402
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City | SACRAMENTO
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State | CA
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Zip | 95823-2632
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Country | US
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Telephone | 916-883-2244
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Fax |
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Provider Business Mailing Address
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Address Line | 7275 E SOUTHGATE DR STE 402
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City | SACRAMENTO
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State | CA
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Zip | 95823-2632
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Country | US
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Telephone | 916-883-2244
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/TREASURER/SECRETARY
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Name | ADEPEJU B GEORGE
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Credential | PA
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Telephone | 916-879-4157
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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