Provider Demographics
NPI:1073911392
Name:CARE PROVIDERS AT ARDEN LLC
Entity Type:Organization
Organization Name:CARE PROVIDERS AT ARDEN LLC
Other - Org Name:CARE PROVIDERS AT ARDEN
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:APUYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-275-6187
Mailing Address - Street 1:4448 ARDEN WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95864-3154
Mailing Address - Country:US
Mailing Address - Phone:916-489-1883
Mailing Address - Fax:916-489-1884
Practice Address - Street 1:4448 ARDEN WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95864-3154
Practice Address - Country:US
Practice Address - Phone:916-489-1883
Practice Address - Fax:916-489-1884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-18
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA347003892310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility