MEDICARE: CHICO REHABILITATION HOSPITAL, 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

General Provider Information

NPI Number	:	1427016740
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHICO REHABILITATION HOSPITAL, LLC

Provider Business Mailing Address
First Line	:	2850 SIERRA SUNRISE TER
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95928-8401
Country	:	US
Telephone Number	:	530-894-1010
Fax Number	:

Provider Business Practice Location Address
First Line	:	2850 SIERRA SUNRISE TER
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95928-8401
Country	:	US
Telephone Number	:	530-894-1010
Fax Number	:	530-894-0147

Authorized Official
Title or Position	:	OWNER
Name	:	DONALD WALTER GORMLY
Credential	:
Telephone Number	:	714-907-7677

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	11/13/2020

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