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General NPI Number Information
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NPI Number | 1275697658
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Entity Type | Organization
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Legal Business Name | BLC GLENWOOD GARDENS SNF LH LLC
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 350 CALLOWAY DR BUILDING 'C'
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City | BAKERSFIELD
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State | CA
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Zip | 93312-2974
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Country | US
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Telephone | 661-587-0182
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Fax | 661-587-8053
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Provider Business Mailing Address
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Address Line | 350 CALLOWAY DR BUILDING 'C'
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City | BAKERSFIELD
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State | CA
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Zip | 93312-2974
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Country | US
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Telephone | 661-587-0182
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Fax | 661-587-8053
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Authorized Official
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Title or Position | ASSISTANT SECRETARY
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Name | ANNA F.C. MUNOZ
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Credential |
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Telephone | 414-918-5443
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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 | 120000555
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License Number State | CA
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