# SEBASTOPOL CONVALESCENT HOSPITAL

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

## Provider details

- **NPI number:** 1568459147
- **Authorized official:** MR. KENNETH CHAMBERS (OFFICE MANAGER)
- **Authorized official phone:** (707) 823-7855

## Contact information

- **Practice address:** 477 PETALUMA AVE, SEBASTOPOL, CA 95472-4206
- **Practice address phone:** (707) 823-7855
- **Practice address fax:** (707) 823-8047
- **Mailing address:** 477 PETALUMA AVE, SEBASTOPOL, CA 95472-4206
- **Mailing address phone:** (707) 823-7855
- **Mailing address fax:** (707) 823-8047

## Taxonomy

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

## Other

- **Enumeration date:** 09/29/2005
- **Last updated:** 06/20/2008