- Enrollment id
- O20180214000056
- Enrollment state
- CO
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1114439262
- Multiple npi flag
- N
- Ccn
- 555913
- Associate id
- 5294095113
- Organization name
- AHC HEALTHCARE OF SACRAMENTO LLC
- Doing business as name
- ADVANCED HEALTH CARE OF SACRAMENTO
- Incorporation date
- 2020-12-09
- Incorporation state
- CA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- ADVANCED HEALTH CARE OF SACRAMENTO
- Affiliation entity name
- ADVANCED HEALTH CARE
- Affiliation entity id
- 11
- Address line 1
- 1411 EXPO PKWY
- City
- SACRAMENTO
- State
- CA
- Zip code
- 958154230