Provider Demographics
NPI:1053835876
Name:NELU'S HOME CARE
Entity Type:Organization
Organization Name:NELU'S HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSEE
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:STIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-757-0918
Mailing Address - Street 1:4941 TYLER ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95841-3436
Mailing Address - Country:US
Mailing Address - Phone:916-757-0918
Mailing Address - Fax:
Practice Address - Street 1:4982 TYLER ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95841-3437
Practice Address - Country:US
Practice Address - Phone:916-757-0918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-02
Last Update Date:2017-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA347000553310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility