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General NPI Number Information
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NPI Number | 1902291867
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Entity Type | Organization
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Legal Business Name | NICOBRE HEALTH SERVICES
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Dates
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Enumeration Date | 03/30/2015
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Last Update Date | 03/25/2016
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Provider Practice Location Address
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Address Line | 3301 ARENA BLVD #87
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City | SACRAMENTO
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State | CA
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Zip | 95834-2518
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Country | US
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Telephone | 646-533-5738
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Fax |
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Provider Business Mailing Address
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Address Line | 3301 ARENA BLVD #87
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City | SACRAMENTO
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State | CA
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Zip | 95834-2518
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Country | US
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Telephone | 646-533-5738
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JANICE L PIERINI
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Credential | RN
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Telephone | 646-533-5738
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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 | 391011
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License Number State | CA
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