Mackellah Home

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

347000955 Issued in CA

Legal business name

MACKELLAH HOME

Practice address

6813 Marinvale Dr
Citrus Heights, CA 95621-1937

Phone

(916) 725-6348

NPI assigned

Oct 15, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Nelson Santos Jacinto

Title

Owner

Phone

(916) 725-6348

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215475200000",
    "number": "1043300320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6813 MARINVALE DR",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956211937",
            "telephone_number": "916-725-6348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6813 MARINVALE DR",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956211937",
            "telephone_number": "916-725-6348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACKELLAH HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-15",
        "last_updated": "2008-07-08",
        "status": "A",
        "authorized_official_last_name": "JACINTO",
        "authorized_official_first_name": "NELSON",
        "authorized_official_middle_name": "SANTOS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-725-6348",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "CA",
            "license": "347000955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE HOME",
            "identifier": "34DP",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Luxottica of America Inc
• Casidee R Lynch, PA-C
• Alexis Dyann Lyons
• Teresa Macdonald
• Joshua Stephen Macias
• Kathryn Leah Maclean, RD
• Diana T Macneill, MFTI
• Madison Calee Madeira
• Lauren Maes
• Magnificent Home Health Services LLC

• Adult Care Home Facility in Citrus Heights, CA
• Providers in Citrus Heights, CA by specialty
• Adult Care Home Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.