Provider Demographics
NPI:1578605630
Name:CARE ADMINISTRATION AND MANAGEMENT PROFESSIONALS, INC.
Entity Type:Organization
Organization Name:CARE ADMINISTRATION AND MANAGEMENT PROFESSIONALS, INC.
Other - Org Name:SUNDALE HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:925-560-0124
Mailing Address - Street 1:P.O. BOX 112
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568
Mailing Address - Country:US
Mailing Address - Phone:925-560-0124
Mailing Address - Fax:925-560-0125
Practice Address - Street 1:6777 AMADOR VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-2001
Practice Address - Country:US
Practice Address - Phone:925-556-0782
Practice Address - Fax:925-560-0125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALTC60892F315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALTC60892FMedicaid