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General NPI Number Information
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NPI Number | 1629164686
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Entity Type | Organization
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Legal Business Name | MACARTHUR CARE CENTER LLC
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 06/03/2009
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Provider Practice Location Address
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Address Line | 309 MACARTHUR BLVD
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City | OAKLAND
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State | CA
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Zip | 94610-3233
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Country | US
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Telephone | 510-836-3777
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Fax | 510-836-0516
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Provider Business Mailing Address
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Address Line | 309 MACARTHUR BLVD
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City | OAKLAND
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State | CA
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Zip | 94610-3233
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Country | US
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Telephone | 510-836-3777
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Fax | 510-836-0516
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Authorized Official
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Title or Position | PRESIDENT
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Name | RANDAL KLEIS
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Credential |
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Telephone | 425-820-9750
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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 | 020000061
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License Number State | CA
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