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General NPI Number Information
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NPI Number | 1114097557
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Entity Type | Organization
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Legal Business Name | COVIA COMMUNITIES
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 01/13/2022
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Provider Practice Location Address
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Address Line | 5555 MONTGOMERY DR
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City | SANTA ROSA
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State | CA
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Zip | 95409-8846
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Country | US
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Telephone | 707-538-8400
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Fax | 707-579-6997
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Provider Business Mailing Address
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Address Line | 2185 N CALIFORNIA BLVD STE 215
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City | WALNUT CREEK
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State | CA
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Zip | 94596-3566
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Country | US
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Telephone | 925-956-7400
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Fax | 925-407-0060
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Authorized Official
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Title or Position | CFO
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Name | DIANA JAMISON
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Credential |
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Telephone | 925-953-7446
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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 | 490107656
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License Number State | CA
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