Agelong Home Care, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

347005440 Issued in CA

Legal business name

AGELONG HOME CARE, LLC

Practice address

6862 Gloria Dr
Sacramento, CA 95831-2440

Phone

(916) 929-2598

NPI assigned

Oct 26, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Judy J PengNPI 1487032371

Title

Adminstrator

Phone

(916) 929-2598

Specialties & licenses 1

Addresses

Practitioners 1

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

• Judy J Peng

  • Nursing Home Administrator
  • Sacramento, CA
  • NPI 1487032371
  NPD (past) Authorized official

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

{
    "created_epoch": "1445817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445817600000",
    "number": "1780056143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6862 GLORIA DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958312440",
            "telephone_number": "916-929-2598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6862 GLORIA DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958312440",
            "telephone_number": "916-929-2598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGELONG HOME CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-26",
        "last_updated": "2015-10-26",
        "status": "A",
        "authorized_official_last_name": "PENG",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINSTRATOR",
        "authorized_official_telephone_number": "916-929-2598",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "347005440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Daven John Agarrado
• Oma N Agbai, MD
• Thuy Vo Agbodike
• Vanessa Agboli Clarke, NP
• Jackie Lynn Agee, M.D.
• Agen Inc
• Michelle Ashley Ager
• Ashna Aggarwal, MD
• Gaurav Aggarwal, MD
• Pooja Aggarwal, MD

• Assisted Living Facility in Sacramento, CA
• Providers in Sacramento, 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 Oct 26, 2015; 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.