=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730221268
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHAYA CENTERS, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/12/2007
-----------------------------------------------------
Last Update Date | 09/28/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2150 PYRAMID DR
-----------------------------------------------------
City | EL SOBRANTE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94803-3220
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 510-758-9600
-----------------------------------------------------
Fax | 510-758-4003
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2150 PYRAMID DR
-----------------------------------------------------
City | EL SOBRANTE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94803-3220
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 510-758-9600
-----------------------------------------------------
Fax | 510-758-4003
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MISS LINDA MARY JOSEPH
-----------------------------------------------------
Credential | NHAP, MBA
-----------------------------------------------------
Telephone | 510-758-3100
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 314000000X
-----------------------------------------------------
Taxonomy Name | Skilled Nursing Facility
-----------------------------------------------------
License Number | 140000102
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------