Provider Demographics
NPI:1023236049
Name:HEALTH FOR ALL, INC.,
Entity type:Organization
Organization Name:HEALTH FOR ALL, INC.,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHUCK
Authorized Official - Middle Name:
Authorized Official - Last Name:WIESEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-441-2811
Mailing Address - Street 1:420 I STREET
Mailing Address - Street 2:SUITE 7
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95814-2319
Mailing Address - Country:US
Mailing Address - Phone:916-441-2811
Mailing Address - Fax:916-441-2876
Practice Address - Street 1:2730 FLORIN RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95822-4560
Practice Address - Country:US
Practice Address - Phone:916-391-5591
Practice Address - Fax:916-391-0264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA070000532261QA0600X
261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAADU70119FMedicare UPIN