Healthcare Provider Details

I. General information

NPI: 1629242599
Provider Name (Legal Business Name): NAPA SKILLED NURSING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2008
Last Update Date: 04/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2465 REDWOOD RD
NAPA CA
94558-3103
US

IV. Provider business mailing address

800 S B ST SUITE 100
SAN MATEO CA
94401-4272
US

V. Phone/Fax

Practice location:
  • Phone: 707-255-3012
  • Fax: 707-255-1015
Mailing address:
  • Phone: 650-347-9500
  • Fax: 650-347-9400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. HANNA F HANHAN
Title or Position: CFO
Credential:
Phone: 650-347-9500