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Organization
SHATTUCK HEALTHCARE INC. DBA ELMWOOD NURSING AND REHABILITATION CENTER
Active
Organization
SHATTUCK HEALTHCARE INC. DBA ELMWOOD NURSING AND REHABILITATION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LUZVIMINDA G LUKBAN (ADMINISTRATOR)
(510) 665-2800
Entity
Organization
Contact information
Practice address
2829 SHATTUCK AVE, BERKELEY, CA 94705-1037
(510) 665-2800
(510) 665-2808
Mailing address
2829 SHATTUCK AVE, BERKELEY, CA 94705-1037
(510) 665-2800
(510) 665-2808
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC55819F
—
CA
Enumeration date
08/05/2006
Last updated
08/22/2020
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