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General NPI Number Information
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NPI Number | 1861902462
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Entity Type | Organization
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Legal Business Name | CVVG MANAGEMENT, LLC
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Dates
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Enumeration Date | 10/09/2017
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Last Update Date | 10/09/2017
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Provider Practice Location Address
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Address Line | 5400 STINE RD
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City | BAKERSFIELD
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State | CA
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Zip | 93313-2825
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Country | US
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Telephone | 661-398-8802
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Fax | 661-837-8700
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Provider Business Mailing Address
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Address Line | 5400 STINE RD
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City | BAKERSFIELD
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State | CA
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Zip | 93313-2825
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Country | US
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Telephone | 661-398-8802
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Fax | 661-837-8700
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Authorized Official
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Title or Position | PRESIDENT
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Name | VIRGINIA GARCIA
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Credential |
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Telephone | 661-398-8802
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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 | 157208773
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License Number State | CA
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