Healthcare Provider Details

I. General information

NPI: 1992722813
Provider Name (Legal Business Name): PLEASANT CARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

523 HAYES LN
PETALUMA CA
94952-4011
US

IV. Provider business mailing address

2258 FOOTHILL BLVD STE 6
LA CANADA CA
91011-1476
US

V. Phone/Fax

Practice location:
  • Phone: 707-763-2457
  • Fax: 707-763-7210
Mailing address:
  • Phone: 818-248-9808
  • Fax: 818-541-7072

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: JOSEPH PADRE
Title or Position: DIRECTOR OF REIMBURSEMENT
Credential:
Phone: 818-248-9808