Healthcare Provider Details

I. General information

NPI: 1699827089
Provider Name (Legal Business Name): CF MADERA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 02/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 SOUTH A STREET
MADERA CA
93638
US

IV. Provider business mailing address

517 SOUTH A STREET
MADERA CA
93638
US

V. Phone/Fax

Practice location:
  • Phone: 559-673-9228
  • Fax: 559-673-1279
Mailing address:
  • Phone: 559-673-9228
  • Fax: 559-673-1279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number040000118
License Number StateCA

VIII. Authorized Official

Name: JACOB WINTNER
Title or Position: MANAGER
Credential:
Phone: 323-651-1808