Basic Information
| Provider Information | |||||||||
| NPI: | 1932286168 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | EL HOGAR COMMUNITY SERVICES INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3870 ROSIN CT STE 130 | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958341647 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9163631553 | ||||||||
| FaxNumber: | 9163631638 | ||||||||
| Practice Location | |||||||||
| Address1: | 3870 ROSIN CT STE 130 | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958341647 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9163631553 | ||||||||
| FaxNumber: | 9163631638 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2006 | ||||||||
| LastUpdateDate: | 02/02/2018 | ||||||||
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| AuthorizedOfficialLastName: | ESKOW | ||||||||
| AuthorizedOfficialFirstName: | GENELLE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHIEF EXECUTIVE OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 9164410226 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | LCSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0850X | 34BY | CA | N | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health | 261QM0850X | N | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health | 390200000X | N | 193400000X SINGLE SPECIALTY GROUP | Student, Health Care | Student in an Organized Health Care Education/Training Program | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.