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General NPI Number Information
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NPI Number | 1083678791
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Entity Type | Organization
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Legal Business Name | BARTON HEALTHCARE SYSTEM
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Dates
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Enumeration Date | 04/12/2006
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Last Update Date | 08/17/2023
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Provider Practice Location Address
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Address Line | 2092 LAKE TAHOE BLVD STE 500
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City | SOUTH LAKE TAHOE
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State | CA
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Zip | 96150-6429
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Country | US
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Telephone | 530-543-5581
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Fax | 530-541-2653
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Provider Business Mailing Address
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Address Line | 2092 LAKE TAHOE BLVD STE 500
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City | SOUTH LAKE TAHOE
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State | CA
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Zip | 96150-6422
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Country | US
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Telephone | 530-543-5581
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Fax | 530-541-2653
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Authorized Official
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Title or Position | CEO
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Name | MR. CLINTON PURVANCE
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Credential |
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Telephone | 530-541-3420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 1863HPC13
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 100000174
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License Number State | CA
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