# G & R ALAMEDA HEALTHCARE SERVICES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Crown Bay Nursing and Rehabilitation Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114119054
- **Authorized official:** MR. TONY AGONCILLO (FINANCE MANAGER)
- **Authorized official phone:** (626) 304-6900

## Contact information

- **Practice address:** 508 WESTLINE DR, ALAMEDA, CA 94501-5847
- **Practice address phone:** (510) 521-5765
- **Practice address fax:** (510) 521-1977
- **Mailing address:** 445 S FAIR OAKS AVE, PASADENA, CA 91105-2632
- **Mailing address phone:** (626) 304-6900
- **Mailing address fax:** (626) 564-2617

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 08/14/2007
- **Last updated:** 11/19/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZZR06103H | — | CA |