Basic Information
| Provider Information | |||||||||
| NPI: | 1417088782 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | COMMUNICARE HEALTH CENTERS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 950 SACRAMENTO AVE | ||||||||
| Address2: | |||||||||
| City: | WEST SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956051904 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9163711966 | ||||||||
| FaxNumber: | 9163712067 | ||||||||
| Practice Location | |||||||||
| Address1: | 950 SACRAMENTO AVE | ||||||||
| Address2: | |||||||||
| City: | WEST SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956051904 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9163711966 | ||||||||
| FaxNumber: | 9163712067 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/08/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | AFFRIME | ||||||||
| AuthorizedOfficialFirstName: | ROBIN | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 5307581205 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.