Provider Demographics
NPI:1780431817
Name:SOQUEL CARE LLC
Entity type:Organization
Organization Name:SOQUEL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:SUCHOMEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-416-4285
Mailing Address - Street 1:6205 RUTHERFORD CANYON RD
Mailing Address - Street 2:
Mailing Address - City:LOOMIS
Mailing Address - State:CA
Mailing Address - Zip Code:95650-9472
Mailing Address - Country:US
Mailing Address - Phone:916-416-4285
Mailing Address - Fax:
Practice Address - Street 1:2990 SOQUEL AVE
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-1412
Practice Address - Country:US
Practice Address - Phone:916-416-4285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility