Healthcare Provider Details

I. General information

NPI: 1396832465
Provider Name (Legal Business Name): GARFIELD NURSING HOME, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2006
Last Update Date: 09/22/2022
Certification Date: 09/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1451 28TH AVE
OAKLAND CA
94601-1632
US

IV. Provider business mailing address

1080 MARINA VILLAGE PKWY SUITE 100
ALAMEDA CA
94501-6427
US

V. Phone/Fax

Practice location:
  • Phone: 510-261-9191
  • Fax: 510-533-5630
Mailing address:
  • Phone: 510-337-7950
  • Fax: 510-337-7969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberLTC 90070F
License Number StateCA

VIII. Authorized Official

Name: LORENA LOPEZ
Title or Position: PROVIDER RELATIONS SUPERVISOR
Credential:
Phone: 510-292-7024