# CHRISTIAN RETIREMENT CENTER OF NORTHERN CALIFORNIA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bethesda Home
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194835017
- **Authorized official:** MS. LOVIAN W EKPENYONG N.H.A. (ADMINISTRATOR)
- **Authorized official phone:** (707) 342-8398

## Contact information

- **Practice address:** 22427 MONTGOMERY ST, HAYWARD, CA 94541-3945
- **Practice address phone:** (510) 538-8300
- **Practice address fax:** (510) 538-8443
- **Mailing address:** 22427 MONTGOMERY ST, HAYWARD, CA 94541-3945
- **Mailing address phone:** (510) 538-8300
- **Mailing address fax:** (510) 538-8443

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 020000013 | CA | Yes |

## Other

- **Enumeration date:** 08/30/2006
- **Last updated:** 08/15/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZZR06370F | — | CA |