| 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 |