Healthcare Provider Details

I. General information

NPI: 1386602613
Provider Name (Legal Business Name): SHERWOOD OAKS ENTERPRISES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 DANA ST
FORT BRAGG CA
95437-4506
US

IV. Provider business mailing address

130 DANA ST
FORT BRAGG CA
95437-4506
US

V. Phone/Fax

Practice location:
  • Phone: 707-964-6333
  • Fax: 707-964-1596
Mailing address:
  • Phone: 707-964-6333
  • Fax: 707-964-1596

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. JOSEPH C. REDING
Title or Position: ADMINISTRATOR
Credential: NURSING HOME ADMIN.
Phone: 707-964-6333