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General NPI Number Information
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NPI Number | 1568719813
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Entity Type | Organization
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Legal Business Name | PENN VALLEY SEVENTH-DAY ADVENTIST CHURCH
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Dates
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Enumeration Date | 08/06/2012
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Last Update Date | 08/06/2012
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Provider Practice Location Address
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Address Line | 17645 PENN VALLEY DR
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City | PENN VALLEY
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State | CA
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Zip | 95946-9998
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Country | US
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Telephone | 530-432-2540
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Fax | 530-432-2479
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Provider Business Mailing Address
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Address Line | PO BOX 23165
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City | PLEASANT HILL
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State | CA
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Zip | 94523-0165
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Country | US
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Telephone | 925-685-4300
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Fax | 925-685-4380
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Authorized Official
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Title or Position | DIRECTOR PROPERTY & RISK MANAGEMENT
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Name | MR. RICHARD MAGNUSON JR.
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Credential |
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Telephone | 925-685-4300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 297004181
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License Number State | CA
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