Provider Demographics
NPI:1780051813
Name:SST SENIOR CARE, LLC
Entity type:Organization
Organization Name:SST SENIOR CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DINESH
Authorized Official - Middle Name:
Authorized Official - Last Name:SAWHNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-593-9111
Mailing Address - Street 1:825 E 18TH ST
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-2835
Mailing Address - Country:US
Mailing Address - Phone:925-706-7944
Mailing Address - Fax:925-706-1290
Practice Address - Street 1:825 E 18TH ST
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-2835
Practice Address - Country:US
Practice Address - Phone:925-706-7944
Practice Address - Fax:925-706-1290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-24
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA079200389310400000X, 311500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility