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DIVINE FAMILY CARE LLC NPI 1891107231


NPI Information

NPI: 1891107231
Provider Name: DIVINE FAMILY CARE LLC
Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization

CLIA Number: 05D1092873

Address:
8194 SUNRISE BLVD
CITRUS HEIGHTS, CA
ZIP 95610
Phone: (916) 600-7989
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DIVINE FAMILY CARE LLC is an intermediate care facility mentally retarded in Citrus Heights, CA. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. DIVINE FAMILY CARE LLC NPI is 1891107231. The provider is registered as an organization entity type.

The provider's business location address is:

8194 SUNRISE BLVD
CITRUS HEIGHTS, CA
ZIP 95610-535
Phone: (916) 600-7989

The provider's authorized official is Georgenia Chiegeonu Aka .
The authorized official title is Administrator and has the following contact phone number (916) 600-7989.

The CLIA number assigned to this NPI record is 05D1092873 - intermediate care facility for mentally retarded with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/20/2014 and was last updated on 5/20/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1315P00000XIntermediate Care Facility, Intellectual DisabilitiesYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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