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General NPI Number Information
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NPI Number | 1861338972
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Entity Type | Organization
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Legal Business Name | GLEN CREEK VILLA
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Dates
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Enumeration Date | 04/29/2026
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Last Update Date | 04/29/2026
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Provider Practice Location Address
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Address Line | 8510 ELM AVE
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City | ORANGEVALE
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State | CA
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Zip | 95662-2612
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Country | US
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Telephone | 916-988-8285
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Fax | 916-988-8285
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Provider Business Mailing Address
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Address Line | 8510 ELM AVENUE
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City | ORANGEVALE
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State | CA
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Zip | 95662
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Country | US
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Telephone | 916-988-8285
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Fax | 916-988-8285
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Authorized Official
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Title or Position | LICENSEE
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Name | WILLIAM GEORGE OSANU
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Credential |
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Telephone | 916-298-4402
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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 |
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