Jackson River Holdings LLC
Skilled Nursing Facility in Livermore, CA. Organization (NPI-2).
NPI number1962034496
StatusActive
Last updated in NPPESFeb 12, 2020
Details
- NPI
- 1962034496
- Entity type
- Organization (NPI-2)
- Legal business name
- Jackson River Holdings LLC
- Organization subpart
- No
- Enumeration date
- Feb 12, 2020
- Certification date
- Feb 12, 2020
- Last updated
- Feb 12, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 314000000X | Skilled Nursing Facility | – | – | Yes |
Other names
- Stratford Villa Post-Acute (Doing Business As)
Practice location
752 Holmes StLivermore, CA 94550-4229
Phone 925-447-2280
Mailing address
16885 W Bernardo Dr Ste 216San Diego, CA 92127-1620
Phone 760-331-3177
Authorized official
Myrna De Guzman
Corporate Controller
7603313177
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