Healthcare Provider Details

I. General information

NPI: 1326734625
Provider Name (Legal Business Name): HILBORN CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2023
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 SONOMA AVE
SANTA ROSA CA
95404-4715
US

IV. Provider business mailing address

3700 HILBORN RD STE 800
FAIRFIELD CA
94534-7997
US

V. Phone/Fax

Practice location:
  • Phone: 707-544-7750
  • Fax:
Mailing address:
  • Phone: 707-439-3871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JOSEKUTTY JOSE
Title or Position: CEO
Credential:
Phone: 925-999-0004