Provider Demographics
NPI:1093605883
Name:SYCAMORE RESIDENTIAL CARE CENTER B LLC
Entity type:Organization
Organization Name:SYCAMORE RESIDENTIAL CARE CENTER B LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NADER
Authorized Official - Middle Name:
Authorized Official - Last Name:NASSAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-595-9991
Mailing Address - Street 1:4545 SYCAMORE AVE # B
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95841-4509
Mailing Address - Country:US
Mailing Address - Phone:916-595-9991
Mailing Address - Fax:
Practice Address - Street 1:4545 SYCAMORE AVE # B
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95841-4509
Practice Address - Country:US
Practice Address - Phone:916-595-9991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-03
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility