# GERI-CARE IV, LLC

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

## Provider details

- **NPI number:** 1609857275
- **Authorized official:** MR. RICHARD L TERRELL MBA (ADMINISTRATOR)
- **Authorized official phone:** (661) 949-5524

## Contact information

- **Practice address:** 44567 15TH ST W, LANCASTER, CA 93534-2803
- **Practice address phone:** (661) 949-5524
- **Practice address fax:** (661) 949-5140
- **Mailing address:** 44567 15TH ST W, LANCASTER, CA 93534-2803
- **Mailing address phone:** (661) 949-5524
- **Mailing address fax:** (661) 949-5140

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 920000122 | CA | Yes |

## Other

- **Enumeration date:** 11/09/2005
- **Last updated:** 12/19/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | LTM90003G | — | CA |