NPI | 1124808423 |
---|---|
Doing Business As | THE VINTAGE FARMHOUSE |
Entity Type | Organization |
Authorized Contact | KIM TILLER Licensee/Administrator 916-591-0426 |
Organization Subpart ? | No |
Primary Taxonomy | 376G00000X Nursing Home Administrator |
Additional Taxonomies | 251G00000X Hospice Care, Community Based |
Enumeration Date | 2023-10-03 |
Last Update Date | 2023-10-03 |