Provider Demographics
NPI:1699542555
Name:WHOLESOME ELDERLY CARE HOMES, LLC
Entity type:Organization
Organization Name:WHOLESOME ELDERLY CARE HOMES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING-MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:FAAMAUSILI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-670-2647
Mailing Address - Street 1:16930 OAK TREE AVE
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:96022-9683
Mailing Address - Country:US
Mailing Address - Phone:916-670-2647
Mailing Address - Fax:916-604-9959
Practice Address - Street 1:5332 T ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819-4841
Practice Address - Country:US
Practice Address - Phone:916-670-2647
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility