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General NPI Number Information
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NPI Number | 1831596220
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Entity Type | Organization
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Legal Business Name | SUPPORT SOLUTIONS
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Dates
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Enumeration Date | 12/01/2014
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Last Update Date | 12/01/2014
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Provider Practice Location Address
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Address Line | 559 16TH ST
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City | OAKLAND
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State | CA
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Zip | 94612-1515
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Country | US
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Telephone | 916-202-5609
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Fax | 916-673-6059
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Provider Business Mailing Address
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Address Line | 559 16TH ST
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City | OAKLAND
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State | CA
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Zip | 94612-1515
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Country | US
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Telephone | 916-202-5609
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Fax | 916-673-6059
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Authorized Official
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Title or Position | OWNDER
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Name | JAN L SPEER
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Credential | RD
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Telephone | 916-202-5609
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number | 504029
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License Number State | CA
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