Healthcare Provider Details

I. General information

NPI: 1215501556
Provider Name (Legal Business Name): RIO BRAVO CONGREGATE LIVING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2021
Last Update Date: 05/19/2021
Certification Date: 05/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 PRESTON CT
BAKERSFIELD CA
93309-1449
US

IV. Provider business mailing address

5900 PRESTON CT
BAKERSFIELD CA
93309-1449
US

V. Phone/Fax

Practice location:
  • Phone: 661-742-1083
  • Fax: 661-742-1143
Mailing address:
  • Phone: 661-742-1083
  • Fax: 661-742-1143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. ARNIE P BELLA-DELA ROSA
Title or Position: ADMINISTRATOR
Credential:
Phone: 661-496-2802