Provider Demographics
NPI:1144710559
Name:G&A CANTILLER INC
Entity type:Organization
Organization Name:G&A CANTILLER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARACELI
Authorized Official - Middle Name:A
Authorized Official - Last Name:CANTILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-803-0815
Mailing Address - Street 1:9616 RICHLYN WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95757-4034
Mailing Address - Country:US
Mailing Address - Phone:916-803-0815
Mailing Address - Fax:
Practice Address - Street 1:8006 BUCKS HARBOR WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95828-5435
Practice Address - Country:US
Practice Address - Phone:916-689-5491
Practice Address - Fax:916-627-1307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-11
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility