Provider Demographics
NPI:1902291867
Name:NICOBRE HEALTH SERVICES
Entity Type:Organization
Organization Name:NICOBRE HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:L
Authorized Official - Last Name:PIERINI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:646-533-5738
Mailing Address - Street 1:3301 ARENA BLVD
Mailing Address - Street 2:#87
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-2518
Mailing Address - Country:US
Mailing Address - Phone:646-533-5738
Mailing Address - Fax:
Practice Address - Street 1:3301 ARENA BLVD
Practice Address - Street 2:#87
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-2518
Practice Address - Country:US
Practice Address - Phone:646-533-5738
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-30
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA391011251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health