| NPI | 1679505572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALVIN WADE CALLAWAY Administrator 916-985-3641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: CA 030000040) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2024-11-05 |