Healthcare Provider Details

I. General information

NPI: 1851203400
Provider Name (Legal Business Name): GAHC4 MADERA CA TRS SUB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N WESTBERRY BLVD
MADERA CA
93637-6005
US

IV. Provider business mailing address

500 N WESTBERRY BLVD
MADERA CA
93637-6005
US

V. Phone/Fax

Practice location:
  • Phone: 559-673-2345
  • Fax: 559-673-4536
Mailing address:
  • Phone: 559-673-2345
  • Fax: 559-673-4536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: DEBRA SANCHEZ
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 559-673-2345