Healthcare Provider Details

I. General information

NPI: 1265934632
Provider Name (Legal Business Name): DANUBE RIVER HOLDINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2018
Last Update Date: 03/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6041 FAIR OAKS BLVD
CARMICHAEL CA
95608-4816
US

IV. Provider business mailing address

16885 W BERNARDO DR STE 216
SAN DIEGO CA
92127-1620
US

V. Phone/Fax

Practice location:
  • Phone: 916-483-8103
  • Fax:
Mailing address:
  • Phone: 858-798-5700
  • Fax:

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: TOBY TILFORD
Title or Position: CO-CEO
Credential:
Phone: 858-774-8342