Provider Demographics
NPI:1699515452
Name:CORINA ELDERLY CARE 1 INC
Entity type:Organization
Organization Name:CORINA ELDERLY CARE 1 INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSEE
Authorized Official - Prefix:
Authorized Official - First Name:CORINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAGNEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-687-3872
Mailing Address - Street 1:8840 KELSEY DR
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-1869
Mailing Address - Country:US
Mailing Address - Phone:916-687-3827
Mailing Address - Fax:
Practice Address - Street 1:8840 KELSEY DR
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-1869
Practice Address - Country:US
Practice Address - Phone:916-687-3827
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility