Healthcare Provider Details

I. General information

NPI: 1376626903
Provider Name (Legal Business Name): ENLOE MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 01/05/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1390 E LASSEN AVE
CHICO CA
95973-7823
US

IV. Provider business mailing address

1531 ESPLANADE ATTN: FINANCE
CHICO CA
95926-3310
US

V. Phone/Fax

Practice location:
  • Phone: 530-332-7479
  • Fax: 530-893-6853
Mailing address:
  • Phone: 530-332-7357
  • Fax: 530-893-6853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number230000081
License Number StateCA

VIII. Authorized Official

Name: MR. CHRISTINE VENARD
Title or Position: DIRECTOR, PFS
Credential:
Phone: 530-332-6331