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General NPI Number Information
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NPI Number | 1477552164
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Entity Type | Organization
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Legal Business Name | UNITED COM-SERVE
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Dates
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Enumeration Date | 07/15/2005
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Last Update Date | 06/24/2013
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Provider Practice Location Address
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Address Line | 1260 WILLIAMS WAY
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City | YUBA CITY
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State | CA
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Zip | 95991-2400
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Country | US
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Telephone | 530-790-3000
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Fax | 530-751-4894
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Provider Business Mailing Address
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Address Line | 1260 WILLIAMS WAY
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City | YUBA CITY
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State | CA
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Zip | 95991-2400
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Country | US
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Telephone | 530-790-3000
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Fax | 530-751-4894
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. EMMA NELSON
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Credential |
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Telephone | 530-790-3002
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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 | 230000176
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License Number State | CA
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