Customcare Home Health Services

Primary specialty

Pediatric Skilled Nursing FacilityTaxonomy code 3140N1450X

License

315193 Issued in CA

Legal business name

CUSTOMCARE HOME HEALTH SERVICES

Practice address

5524 Assmbly Court 58
Sacramento, CA 95823

Phone

(916) 422-7327

Fax

(916) 422-7303

NPI assigned

Feb 12, 2007

Organization subpart

No

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

Authorized official

Name

Kiesha Charlton

Title

Billing Manager

Phone

(916) 422-7327

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720120330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5524 ASSEMBLY CT STE 58",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958232606",
            "telephone_number": "916-422-7327",
            "fax_number": "916-422-7303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5524 ASSMBLY COURT 58",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95823",
            "telephone_number": "916-422-7327",
            "fax_number": "916-422-7303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOMCARE HOME HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHARLTON",
        "authorized_official_first_name": "KIESHA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "916-422-7327"
    },
    "taxonomies": [
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": "CA",
            "license": "315193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOME HEALTH",
            "identifier": "HHA57540F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Cusic, MHAIII
• Nishareya Cusic
• Price David Cusolito
• Gavin Scott Cusson, PTA
• Alexis Nicole Custer
• Jensen Grace Cutler
• Timothy William Cutler, PHARM.D.
• Donna Jean Cutrer
• Cynthia Gayle Cutter, NURSE PRACTITIONER
• Betsy Cuttle, LCSW

• Pediatric Skilled Nursing Facility in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Pediatric Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.