Provider Demographics
NPI:1992553739
Name:CIMINOCARE
Entity type:Organization
Organization Name:CIMINOCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:J
Authorized Official - Last Name:CIMINO
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:916-704-6275
Mailing Address - Street 1:7920 ALTA SUNRISE DR STE 250
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-7963
Mailing Address - Country:US
Mailing Address - Phone:916-486-9639
Mailing Address - Fax:916-750-5701
Practice Address - Street 1:7920 ALTA SUNRISE DR STE 250
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-7963
Practice Address - Country:US
Practice Address - Phone:916-486-9639
Practice Address - Fax:916-750-5701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA171M00000XOtherCASE MANAGER/CARE COORDINATOR