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General NPI Number Information
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NPI Number | 1215296652
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Entity Type | Organization
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Legal Business Name | AVE MARIA CONVALESCENT HOSPITAL
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Dates
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Enumeration Date | 05/04/2012
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Last Update Date | 02/01/2013
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Provider Practice Location Address
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Address Line | 1249 JOSSELYN CANYON RD
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City | MONTEREY
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State | CA
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Zip | 93940-5265
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Country | US
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Telephone | 831-373-1216
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Fax | 831-242-8980
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Provider Business Mailing Address
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Address Line | 1249 JOSSELYN CANYON RD
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City | MONTEREY
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State | CA
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Zip | 93940-5265
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Country | US
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Telephone | 831-373-1216
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Fax | 831-242-8980
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Authorized Official
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Title or Position | SNF ADMINISTRATOR
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Name | JOHN W MILFORD
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Credential | NHA
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Telephone | 831-373-1216
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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 | 070000009
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License Number State | CA
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