NPIMap

Organization Active NPI

Custom Care Home Health Services Inc

  • Durable Medical Equipment & Medical Supplies
  • Elk Grove, CA
National Provider Identifier
1447502026
Registry record updated Jan 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
CUSTOM CARE HOME HEALTH SERVICES INC
Practice address
8837 Elk Grove Blvd Ste Aandb
Elk Grove, CA 95624-1828
Phone
(916) 714-1155
Fax
(916) 714-1165
NPI assigned
Oct 8, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2020

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

Authorized official

Name
Audrey Acosta
Title
Owner/Operator/Administrator
Phone
(916) 714-1155

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

8837 Elk Grove Blvd Ste Aandb
Elk Grove, CA 95624-1828

Mailing address

PO Box 2792
Elk Grove, CA 95759-2792

Other identifiers 1

IdentifierTypeStateIssuer
1003055195MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Customcare Home Health Services Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578528000000",
    "number": "1447502026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2792",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957592792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8837 ELK GROVE BLVD STE AANDB",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956241828",
            "telephone_number": "916-714-1155",
            "fax_number": "916-714-1165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM CARE HOME HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-08",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A",
        "authorized_official_last_name": "ACOSTA",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_title_or_position": "OWNER/OPERATOR/ADMINISTRATOR",
        "authorized_official_telephone_number": "916-714-1155"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003055195",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2020; 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.