# CRESTHAVEN NURSING HOME

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164590832
- **Authorized official:** MS. MARGARET AMOS (ADMINISTRATOR)
- **Authorized official phone:** (831) 475-3812

## Contact information

- **Practice address:** 740 17TH AVE, SANTA CRUZ, CA 95062-4122
- **Practice address phone:** (831) 475-3812
- **Mailing address:** 740 17TH AVE, SANTA CRUZ, CA 95062-4122
- **Mailing address phone:** (831) 475-3812

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | ZZR18059H | CA | Yes |

## Other

- **Enumeration date:** 12/01/2006
- **Last updated:** 07/09/2008