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Organization
COVENANT CARE CAPITOLA, LLC
Active
Organization
COVENANT CARE CAPITOLA, LLC
Active
Other names
Pacific Coast Manor
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL A SPARKS (DIRECTOR OF REIMBURSEMENT)
(949) 349-1200
Entity
Organization
Contact information
Practice address
1935 WHARF RD, CAPITOLA, CA 95010-2606
(831) 476-0770
(831) 476-0737
Mailing address
120 VANTIS DR STE 200, ALISO VIEJO, CA 92656-2677
(949) 349-1200
(949) 349-1122
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
070000039
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZR06048I
—
CA
Enumeration date
07/08/2005
Last updated
08/14/2026
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