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General NPI Number Information
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NPI Number | 1649184029
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Entity Type | Organization
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Legal Business Name | SPANISH VINES, LLC
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Dates
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Enumeration Date | 10/01/2026
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Last Update Date | 10/01/2026
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Provider Practice Location Address
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Address Line | 7548 GREENHAVEN DR
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City | SACRAMENTO
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State | CA
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Zip | 95831-5610
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Country | US
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Telephone | 916-596-1887
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Fax |
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Provider Business Mailing Address
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Address Line | 2334 WASHINGTON AVE
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City | REDDING
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State | CA
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Zip | 96001-2159
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Country | US
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Telephone | 530-242-8300
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Fax | 530-244-5555
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Authorized Official
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Title or Position | DIRECTOR OF COMPLIANCE
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Name | TREVOR ARTHUR OGDEN
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Credential |
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Telephone | 530-356-8699
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State | NULL
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