Healthcare Provider Details

I. General information

NPI: 1750529129
Provider Name (Legal Business Name): WISH-I-AH SKILLED NURSING & WELLNESS CENTRE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2009
Last Update Date: 01/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35680 WISH I AH RD
AUBERRY CA
93602-9615
US

IV. Provider business mailing address

35680 WISH I AH RD
AUBERRY CA
93602-9615
US

V. Phone/Fax

Practice location:
  • Phone: 559-855-2211
  • Fax: 323-634-1943
Mailing address:
  • Phone: 559-855-2211
  • Fax: 323-634-1943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number040000167
License Number StateCA

VIII. Authorized Official

Name: CHAIM KOLODNY
Title or Position: SR VICE PRESIDENT
Credential: NHA, CMC
Phone: 323-634-1940