Citrus Crest Care Home 2 LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CITRUS CREST CARE HOME 2 LLC

Practice address

6813 Marinvale Dr
Citrus Heights, CA 95621-1937

Phone

(510) 409-7098

NPI assigned

Aug 29, 2022

Organization subpart

No

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

Authorized official

Name

Muamoudou Aidara Soumahoro

Title

Ceo

Phone

(510) 509-7098

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1661731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661731200000",
    "number": "1841910247",
    "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": "510-409-7098"
        },
        {
            "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": "510-409-7098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITRUS CREST CARE HOME 2 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-29",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A",
        "authorized_official_last_name": "SOUMAHORO",
        "authorized_official_first_name": "MUAMOUDOU",
        "authorized_official_middle_name": "AIDARA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "510-509-7098"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hsiang Ju Chung, L.AC.
• John Paul Diamsay Cielo-Dunbar
• Ciminocare
• Delia Ciobanu
• Wendy Ciotti
• Citrus Crest Care Home1
• Citrus Heights Community Healthcare, LLC (Citrus Heights Post Acute)
• Citrus Heights Dental
• Citrus Heights Terrace
• Citrus Plaza Medical Supply

• Assisted Living Facility in Citrus Heights, CA
• Providers in Citrus Heights, 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 Aug 29, 2022; 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.