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General NPI Number Information
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NPI Number | 1548427479
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Entity Type | Organization
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Legal Business Name | CHANNING HOUSE
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 05/19/2008
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Provider Practice Location Address
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Address Line | 850 WEBSTER STREET
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City | PALO ALTO
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State | CA
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Zip | 94301
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Country | US
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Telephone | 650-327-0950
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Fax | 650-324-7585
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Provider Business Mailing Address
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Address Line | 850 WEBSTER STREET
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City | PALO ALTO
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State | CA
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Zip | 94301
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Country | US
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Telephone | 650-327-0950
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Fax | 650-324-7585
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. PATRICIA H SHEA
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Credential | RN SNF ADMINISTRATOR
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Telephone | 650-324-7596
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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 | 220000404
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License Number State | CA
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