Provider Demographics
NPI:1932645645
Name:SACRAMENTO BASED ADULT DAY SERVICE INC.
Entity Type:Organization
Organization Name:SACRAMENTO BASED ADULT DAY SERVICE INC.
Other - Org Name:KINGDOM LIVING ADHC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:THERESA
Authorized Official - Last Name:SUNDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MHCA
Authorized Official - Phone:619-414-4530
Mailing Address - Street 1:620 BERCUT DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95811-0131
Mailing Address - Country:US
Mailing Address - Phone:916-440-7700
Mailing Address - Fax:916-444-7794
Practice Address - Street 1:620 BERCUT DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95811-0131
Practice Address - Country:US
Practice Address - Phone:916-444-7700
Practice Address - Fax:916-444-7794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-19
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care