Healthcare Provider Details

I. General information

NPI: 1194895631
Provider Name (Legal Business Name): COVIA COMMUNITIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 12/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WOOD RD
LOS GATOS CA
95030-6704
US

IV. Provider business mailing address

2185 N CALIFORNIA BLVD STE 215
WALNUT CREEK CA
94596-3566
US

V. Phone/Fax

Practice location:
  • Phone: 408-354-0211
  • Fax: 408-354-4193
Mailing address:
  • Phone: 925-956-7400
  • Fax: 925-407-0060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number070000062
License Number StateCA

VIII. Authorized Official

Name: MITZI HYLAND
Title or Position: VP OF FINANCE/CORPORATE CONTROLLER
Credential:
Phone: 925-956-7410