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NPI Code Detail

MEDICARE: SOLVANG LUTHERAN HOME, INC.

MEDICARE: SOLVANG LUTHERAN HOME, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility0500058CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ZZT06353FOTHERCAMEDI-CAL PROVIDER #

General Provider Information

NPI Number : 1720086077
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOLVANG LUTHERAN HOME, INC.
Provider Business Mailing Address
First Line : 636 ATTERDAG RD
Second Line :
City : SOLVANG
State : CA
Zip : 93463-2604
Country : US
Telephone Number : 805-688-3263
Fax Number : 805-688-8574
Provider Business Practice Location Address
First Line : 636 ATTERDAG RD
Second Line :
City : SOLVANG
State : CA
Zip : 93463-2604
Country : US
Telephone Number : 805-688-3263
Fax Number : 805-688-8574
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. CHRISTOPHER WARD PARKER
Credential :
Telephone Number : 805-688-3263
Provider Enumeration Date : 07/11/2005
Last Update Date : 07/17/2013

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