Healthcare Provider Details

I. General information

NPI: 1831119049
Provider Name (Legal Business Name): NORTHERN CALIFORNIA CONGREGATIONAL RETIREMENT HOMES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 03/22/2023
Certification Date: 03/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8545 CARMEL VALLEY ROAD
CARMEL CA
93923
US

IV. Provider business mailing address

8545 CARMEL VALLEY ROAD
CARMEL CA
93923
US

V. Phone/Fax

Practice location:
  • Phone: 831-624-1281
  • Fax: 831-625-9827
Mailing address:
  • Phone: 831-624-1281
  • Fax: 831-625-9827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: JAY ALAN ZIMMER
Title or Position: PRESIDENT & CEO
Credential:
Phone: 831-626-4707