# COVENANT CARE CALIFORNIA, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Vintage Faire Nursing & Rehabilitation Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437291929
- **Authorized official:** CAROL SPARKS (DIRECTOR OF REIMBURSEMENT)
- **Authorized official phone:** (949) 349-1200

## Contact information

- **Practice address:** 3620 DALE RD, SUITE B, MODESTO, CA 95356-0598
- **Practice address phone:** (209) 521-2094
- **Practice address fax:** (209) 521-6180
- **Mailing address:** 120 VANTIS DR STE 200, ALISO VIEJO, CA 92656-2677
- **Mailing address phone:** (949) 349-1200
- **Mailing address fax:** (949) 349-1122

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 100000366 | CA | Yes |

## Other

- **Enumeration date:** 02/13/2007
- **Last updated:** 08/14/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 206504004 | OSHPD | CA |
| 05 | — | LTC55355H | — | CA |