Provider Demographics
NPI:1366322554
Name:NANA'S HOUSE SOLANO LLC
Entity type:Organization
Organization Name:NANA'S HOUSE SOLANO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOLBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-385-7421
Mailing Address - Street 1:4160 SUISUN VALLEY RD # E610
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-4016
Mailing Address - Country:US
Mailing Address - Phone:510-385-7421
Mailing Address - Fax:
Practice Address - Street 1:720 TAYLOR ST
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-5727
Practice Address - Country:US
Practice Address - Phone:510-385-7421
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management