MEDICARE: SOLANO COUNTY RESOURCE MANAGEMENT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency	4992	CA

General Provider Information

NPI Number	:	1235375288
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOLANO COUNTY RESOURCE MANAGEMENT

Provider Business Mailing Address
First Line	:	675 TEXAS ST STE 5500
Second Line	:
City	:	FAIRFIELD
State	:	CA
Zip	:	94533-6341
Country	:	US
Telephone Number	:	707-784-6765
Fax Number	:

Provider Business Practice Location Address
First Line	:	675 TEXAS ST STE 5500
Second Line	:
City	:	FAIRFIELD
State	:	CA
Zip	:	94533-6341
Country	:	US
Telephone Number	:	707-784-6765
Fax Number	:

Authorized Official
Title or Position	:	SENIOR REHS
Name	:	MR. JEFF BOGGS
Credential	:
Telephone Number	:	707-784-3320

Provider Enumeration Date	:	12/22/2008
Last Update Date	:	12/22/2008

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