Basic Information
| Provider Information | |||||||||
| NPI: | 1922553205 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EL HOGAR COMMUNITY SERVICE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3780 ROSIN CT | ||||||||
| Address2: | STE 110 | ||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958341646 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9164410226 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3870 ROSIN CT | ||||||||
| Address2: | STE 130 | ||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958341620 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9163631553 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2016 | ||||||||
| LastUpdateDate: | 08/17/2016 | ||||||||
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| AuthorizedOfficialLastName: | ESCOW | ||||||||
| AuthorizedOfficialFirstName: | KEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 9165887991 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 343900000X | Y | Transportation Services | Non-emergency Medical Transport (VAN) |
No ID Information.