MEDICARE: S.H.C.C. , INC.

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	314000000X	Skilled Nursing Facility		CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689755456
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	S.H.C.C. , INC.

Provider Business Mailing Address
First Line	:	4700 ELVAS AVE
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95819-2250
Country	:	US
Telephone Number	:	916-454-4700
Fax Number	:	916-451-7962

Provider Business Practice Location Address
First Line	:	4700 ELVAS AVE
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95819-2250
Country	:	US
Telephone Number	:	916-454-4700
Fax Number	:	916-451-7962

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JOHN LUND
Credential	:
Telephone Number	:	805-565-9300

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	08/22/2020

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