Provider Demographics
NPI:1700623626
Name:CURLY ANNE'S RESIDENCE 2, INC ICF/DD-N
Entity type:Organization
Organization Name:CURLY ANNE'S RESIDENCE 2, INC ICF/DD-N
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LOS SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:916-213-3688
Mailing Address - Street 1:6617 RIO DE ONAR WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95757-3411
Mailing Address - Country:US
Mailing Address - Phone:279-333-7317
Mailing Address - Fax:279-333-7317
Practice Address - Street 1:6617 RIO DE ONAR WAY
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95757-3411
Practice Address - Country:US
Practice Address - Phone:279-333-7317
Practice Address - Fax:279-333-7317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility