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General NPI Number Information
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NPI Number | 1851602510
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Entity Type | Organization
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Legal Business Name | CHATEAU AT CARMICHAEL PARK LLC
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Dates
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Enumeration Date | 06/28/2010
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Last Update Date | 06/28/2010
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Provider Practice Location Address
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Address Line | 7125 FAIR OAKS BLVD
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City | CARMICHAEL
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State | CA
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Zip | 95608-6450
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Country | US
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Telephone | 916-481-7105
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Fax | 916-481-1242
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Provider Business Mailing Address
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Address Line | 610 FULTON AVE SUITE 100
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City | SACRAMENTO
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State | CA
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Zip | 95825-4867
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Country | US
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Telephone | 916-485-1441
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Fax | 916-485-1981
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. NANCY M FISHER
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Credential |
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Telephone | 916-485-1441
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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 | 347001523
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License Number State | CA
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