=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851279426
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PADUA CARE HOME
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/22/2025
-----------------------------------------------------
Last Update Date | 08/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8700 MILO CT
-----------------------------------------------------
City | ELK GROVE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95624-1817
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-218-8556
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8708 THETFORD CT
-----------------------------------------------------
City | ELK GROVE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95624-1734
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-218-8556
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SECRETARY
-----------------------------------------------------
Name | ANGELITA R PADUA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 916-218-8556
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 310400000X
-----------------------------------------------------
Taxonomy Name | Assisted Living Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------