Healthcare Provider Details

I. General information

NPI: 1194891051
Provider Name (Legal Business Name): REDWOOD CONVALESCENT HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 03/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22103 REDWOOD ROAD
CASTRO VALLEY CA
94546
US

IV. Provider business mailing address

22103 REDWOOD ROAD
CASTRO VALLEY CA
94546
US

V. Phone/Fax

Practice location:
  • Phone: 510-537-8848
  • Fax: 510-537-3830
Mailing address:
  • Phone: 510-537-8848
  • Fax: 510-537-3830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number020000298
License Number StateCA

VIII. Authorized Official

Name: MRS. LUNINGNING B HOBBS
Title or Position: PRESIDENT OWNER
Credential: NHA
Phone: 510-537-8848