# CONGREGATIONAL CHURCH RETIREMENT COMMUNITY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** AUBURN RAVINE TERRACE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083619365
- **Authorized official:** PETER PEABODY (V.P. HEALTHCARE OPERATIONS)
- **Authorized official phone:** (562) 257-5107

## Contact information

- **Practice address:** 750 AUBURN RAVINE RD, AUBURN, CA 95603-3820
- **Practice address phone:** (530) 823-6131
- **Practice address fax:** (530) 823-9510
- **Mailing address:** 750 AUBURN RAVINE RD, AUBURN, CA 95603-3820
- **Mailing address phone:** (530) 823-6131
- **Mailing address fax:** (530) 823-9510

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 030000172 | CA | Yes |

## Other

- **Enumeration date:** 06/14/2005
- **Last updated:** 02/03/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | LTC90009F | — | CA |