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General NPI Number Information
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NPI Number | 1942620083
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Entity Type | Organization
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Legal Business Name | CREEKVIEW HC LLC
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Dates
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Enumeration Date | 04/16/2014
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Last Update Date | 01/19/2016
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Provider Practice Location Address
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Address Line | 2900 STONERIDGE DRIVE
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City | PLEASANTON
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State | CA
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Zip | 94588-2200
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Country | US
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Telephone | 925-201-4000
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Fax | 925-249-9435
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Provider Business Mailing Address
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Address Line | 2900 STONERIDGE DRIVE
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City | PLEASANTON
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State | CA
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Zip | 94588-2200
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Country | US
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Telephone | 925-201-4000
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Fax | 925-249-9435
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Authorized Official
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Title or Position | MANAGER
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Name | MR. TROY A. BOURNE
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Credential |
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Telephone | 925-227-6802
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 550003252
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License Number State | CA
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