1125 Sir Francis Drake Boulevard Operating Company, LLC
Long Term Care Hospital in Kentfield, CA. Organization (NPI-2).
NPI number1760424261
StatusActive
Last updated in NPPESOct 3, 2023
Details
- NPI
- 1760424261
- Entity type
- Organization (NPI-2)
- Legal business name
- 1125 Sir Francis Drake Boulevard Operating Company, LLC
- Organization subpart
- No
- Enumeration date
- Jun 11, 2006
- Certification date
- Oct 3, 2023
- Last updated
- Oct 3, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 282E00000X | Long Term Care Hospital | 110000358 | CA | Yes |
Other names
- Kentfield Rehabilitation & Specialty Hospital (Doing Business As)
Practice location
1125 Sir Francis Drake BlvdKentfield, CA 94904-1418
Phone 415-456-9680 · Fax 415-485-3696
Mailing address
700 17th St Ste 205Modesto, CA 95354-1249
Phone 209-287-6308 · Fax 209-248-7825
Authorized official
Tammy Jean Thompson
Cfo/Vp
2092876308
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