Healthcare Provider Details

I. General information

NPI: 1922332162
Provider Name (Legal Business Name): HCRC,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2009
Last Update Date: 09/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1832 B ST
HAYWARD CA
94541-3140
US

IV. Provider business mailing address

540 W MONTE VISTA AVE
VACAVILLE CA
95688-3620
US

V. Phone/Fax

Practice location:
  • Phone: 510-538-3866
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number020000041
License Number StateCA

VIII. Authorized Official

Name: PREMA P THEKKEK
Title or Position: VICE PRESIDENT/SECRETARY
Credential:
Phone: 925-457-1150