Marine Residential Care Home

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

347003529 Issued in CA

Legal business name

MARINE RESIDENTIAL CARE HOME

Practice address

9649 Sea Cliff Way
Elk Grove, CA 95758-7131

Phone

(916) 647-3250

Fax

(916) 359-5182

NPI assigned

Feb 9, 2012

Organization subpart

No

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

Authorized official

Name

Juliebeth B Arzadon

Title

Licensee

Phone

(916) 647-3250

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Marine Residential Care Home2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Orange Crest Guest Home

  • Assisted Living Facility
  • Elk Grove, CA
  • NPI 1154695781
  NPD tax ID

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

{
    "created_epoch": "1328745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328745600000",
    "number": "1194098970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9649 SEA CLIFF WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957587131",
            "telephone_number": "916-647-3250",
            "fax_number": "916-359-5182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9649 SEA CLIFF WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957587131",
            "telephone_number": "916-647-3250",
            "fax_number": "916-359-5182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARINE RESIDENTIAL CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-09",
        "last_updated": "2012-02-09",
        "status": "A",
        "authorized_official_last_name": "ARZADON",
        "authorized_official_first_name": "JULIEBETH",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "LICENSEE",
        "authorized_official_telephone_number": "916-647-3250"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "347003529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T1020",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Castillo First Class Mobility
• Maria Kang LLC
• Gabriella Mariano
• Joel Marcel Mariano, FNP
• Maridel Francisco Benigno Rdhap
• Karen Marine, MC
• Kelly Ann Marinello, LCSW
• Elizabeth Mariscal-Van Houten
• Mark David Levine, Elk Grove, Professional Corportation
• Este Ginelle Marks, DO

• Assisted Living Facility in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2012; 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.