Provider Demographics
NPI:1083367247
Name:SOLACIUM HOLDINGS, LLC
Entity type:Organization
Organization Name:SOLACIUM HOLDINGS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHARNELL
Authorized Official - Middle Name:
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-239-6923
Mailing Address - Street 1:5500 MING AVE STE 410
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-4631
Mailing Address - Country:US
Mailing Address - Phone:661-622-4132
Mailing Address - Fax:
Practice Address - Street 1:1470 E MIDDLE AVE
Practice Address - Street 2:
Practice Address - City:SAN MARTIN
Practice Address - State:CA
Practice Address - Zip Code:95046-9534
Practice Address - Country:US
Practice Address - Phone:408-686-4102
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-28
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children