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General NPI Number Information
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NPI Number | 1013718170
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Entity Type | Organization
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Legal Business Name | CARDIFF BEACH, LLC
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Dates
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Enumeration Date | 03/24/2025
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 1116 E LAURIDSEN BLVD
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City | PORT ANGELES
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State | WA
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Zip | 98362-6640
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Country | US
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Telephone | 360-452-9206
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Fax |
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Provider Business Mailing Address
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Address Line | 599 MENLO DR STE 200
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City | ROCKLIN
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State | CA
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Zip | 95765-3725
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Country | US
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Telephone | 916-299-7030
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | RYAN WILLIAMS
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Credential |
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Telephone | 916-945-1248
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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