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Organization
SOUTHERN HUMBOLDT COMMUNITY HEALTHCARE DISTRICT
Active
Organization
SOUTHERN HUMBOLDT COMMUNITY HEALTHCARE DISTRICT
Active
Other names
Jerold Phelps Community Hospital Skilled Nursing Facility
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW E REES (ADMINISTRATOR)
(707) 923-3921
Entity
Organization
Contact information
Practice address
733 CEDAR ST, GARBERVILLE, CA 95542-3201
(707) 923-3921
(707) 923-1456
Mailing address
733 CEDAR ST, GARBERVILLE, CA 95542-3201
(707) 923-3921
(707) 923-1456
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
110000052
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
174988
—
AZ
05
—
272260
—
OR
05
—
3003993
—
WA
01
—
LTC55516F
MEDI-CAL SNF
CA
01
—
ZZZJ1202Z
BLUE SHIELD (HOSPITAL)
CA
Enumeration date
04/23/2007
Last updated
01/18/2022
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