Healthcare Provider Details

I. General information

NPI: 1528107745
Provider Name (Legal Business Name): PINERS NURSING HOME INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 02/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 PUEBLO AVE
NAPA CA
94558-4751
US

IV. Provider business mailing address

1800 PUEBLO AVE
NAPA CA
94558-4751
US

V. Phone/Fax

Practice location:
  • Phone: 707-224-7925
  • Fax: 707-255-0331
Mailing address:
  • Phone: 707-224-7925
  • Fax: 707-255-0331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number110000059
License Number StateCA

VIII. Authorized Official

Name: MALINDA MEEKER
Title or Position: CONTROLLER
Credential:
Phone: 707-224-3123