Provider Demographics
NPI:1831079284
Name:PURE CARE HOME LLC
Entity type:Organization
Organization Name:PURE CARE HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSEE
Authorized Official - Prefix:
Authorized Official - First Name:SID ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:MESLOUB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-254-1412
Mailing Address - Street 1:6355 PERRIN WAY
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-1111
Mailing Address - Country:US
Mailing Address - Phone:916-254-1412
Mailing Address - Fax:
Practice Address - Street 1:6355 PERRIN WAY
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-1111
Practice Address - Country:US
Practice Address - Phone:916-254-1412
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility