Provider Demographics
NPI:1619410370
Name:HEALTH SERVICES SACRAMENTO, LLC
Entity Type:Organization
Organization Name:HEALTH SERVICES SACRAMENTO, LLC
Other - Org Name:MIRACLE-EAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INSURANCE SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:HYLTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-208-7801
Mailing Address - Street 1:1059 E IRON EAGLE DR
Mailing Address - Street 2:SUITE 175
Mailing Address - City:EAGLE
Mailing Address - State:ID
Mailing Address - Zip Code:83616-6855
Mailing Address - Country:US
Mailing Address - Phone:360-208-7801
Mailing Address - Fax:208-475-4507
Practice Address - Street 1:5460 SUNRISE BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-7844
Practice Address - Country:US
Practice Address - Phone:916-245-2550
Practice Address - Fax:360-208-7801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-29
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty