Country Villa Petaluma Healthcare Center

LBN: Petaluma Skilled Nursing & Wellness Centre, Llc
Country Villa Petaluma Healthcare Center is an health care organization with primary practice located at 523 Hayes Ln , Petaluma CA 94952-4011. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Petaluma Skilled Nursing & Wellness Centre, Llc can be contacted via phone (707) 763-2457, or through Reissman, Stephen E. via phone (310) 574-3733.

Contact Information

Primary practice address
523 Hayes Ln Petaluma CA 94952-4011
Phone: (707) 763-2457
Fax: (707) 765-2176
Website:
Map and Directions
Authorized official contact:
Name: Reissman, Stephen E.
Phone: (310) 574-3733

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X

Profile Details

NPI number 1669661716
LBN Legal business name Petaluma Skilled Nursing & Wellness Centre, Llc
DBA Doing business as Country Villa Petaluma Healthcare Center
Authorized official Reissman, Stephen E.
Entity Organization
Organization subpart 1 No
Enumeration date Oct 15th, 2007
Last updated Oct 15th, 2007 - about 19 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669661716 NPPES
California MEDICAID LTC55703F

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