Healthcare Provider Details

I. General information

NPI: 1023923794
Provider Name (Legal Business Name): QUAIL CREST REDDING 1, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 QUARTZ HILL RD
REDDING CA
96003-2101
US

IV. Provider business mailing address

PO BOX 1398
MEDFORD OR
97501-0104
US

V. Phone/Fax

Practice location:
  • Phone: 541-414-6010
  • Fax:
Mailing address:
  • Phone: 541-414-6010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: SHILOH WOOD
Title or Position: CAO
Credential:
Phone: 541-601-2932