# FMSC SAN RAFAEL OPERATING COMPANY LP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pineridge Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376515817
- **Authorized official:** MRS. ANDREA SAAVEDRA (REGIONAL FINANCIAL ANALYST)
- **Authorized official phone:** (707) 208-1940

## Contact information

- **Practice address:** 45 PROFESSIONAL CENTER PKWY, SAN RAFAEL, CA 94903-2702
- **Practice address phone:** (415) 479-3610
- **Mailing address:** 45 PROFESSIONAL CENTER PKWY, SAN RAFAEL, CA 94903-2702
- **Mailing address phone:** (415) 479-3610

## Taxonomy

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

## Other

- **Enumeration date:** 02/07/2006
- **Last updated:** 06/20/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZZR05850M | — | CA |