Provider Demographics
NPI:1760067961
Name:VALINE SENIOR CARE
Entity Type:Organization
Organization Name:VALINE SENIOR CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:B
Authorized Official - Last Name:CIMINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-606-8677
Mailing Address - Street 1:P.O. BOX 7914
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95267
Mailing Address - Country:US
Mailing Address - Phone:209-956-5633
Mailing Address - Fax:916-471-0401
Practice Address - Street 1:966 43RD AVENUE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831
Practice Address - Country:US
Practice Address - Phone:916-694-9400
Practice Address - Fax:916-394-9405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility