MEDICARE: NOVATO HEALTHCARE CENTER, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417152570
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOVATO HEALTHCARE CENTER, LLC

Provider Business Mailing Address
First Line	:	1565 HILL RD
Second Line	:
City	:	NOVATO
State	:	CA
Zip	:	94947-4063
Country	:	US
Telephone Number	:	323-634-1940
Fax Number	:	323-634-1943

Provider Business Practice Location Address
First Line	:	1565 HILL RD
Second Line	:
City	:	NOVATO
State	:	CA
Zip	:	94947-4063
Country	:	US
Telephone Number	:	415-897-6161
Fax Number	:	415-898-0561

Authorized Official
Title or Position	:	MANAGER
Name	:	SHLOMO RECHNITZ
Credential	:
Telephone Number	:	626-800-1191

Provider Enumeration Date	:	06/19/2007
Last Update Date	:	10/19/2022

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