# WILLOW CREEK HEALTHCARE CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SUMMIT CARE LLC
- **Other names:** Willow Creek Healthcare Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1003861089
- **Legal business name:** SUMMIT CARE LLC
- **Authorized official:** MICHAEL T. BERG (ASSISTANT SECRETARY)
- **Authorized official phone:** (505) 468-4752

## Contact information

- **Practice address:** 650 W ALLUVIAL AVE, CLOVIS, CA 93611-6716
- **Practice address phone:** (559) 323-6200
- **Practice address fax:** (559) 323-4665
- **Mailing address:** 650 W ALLUVIAL AVE, CLOVIS, CA 93611-6716
- **Mailing address phone:** (559) 323-6200
- **Mailing address fax:** (559) 323-4665

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 040000418 | CA | Yes |

## Other

- **Enumeration date:** 05/24/2006
- **Last updated:** 02/01/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | LTC55652G | — | CA |