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General NPI Number Information
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NPI Number | 1518962893
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Entity Type | Organization
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Legal Business Name | CATHEDRAL PIONEER CHURCH HOMES NO TWO
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Dates
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Enumeration Date | 06/14/2005
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Last Update Date | 09/16/2014
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Provider Practice Location Address
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Address Line | 415 P ST
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City | SACRAMENTO
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State | CA
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Zip | 95814-5300
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Country | US
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Telephone | 916-442-4906
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Fax | 916-442-8665
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Provider Business Mailing Address
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Address Line | 415 P ST
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City | SACRAMENTO
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State | CA
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Zip | 95814-5300
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Country | US
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Telephone | 916-442-4906
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Fax | 916-442-8665
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Authorized Official
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Title or Position | V.P. OF OPERATIONS
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Name | STUART HARTMAN
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Credential |
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Telephone | 562-257-5100
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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 | 100000072
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License Number State | CA
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