# CALIFORNIA-NEVADA METHODIST HOMES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lake Park Retirement Residence
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629042833
- **Authorized official:** MR. ROBERT E HUBBARD (PRESIDENT AND CEO)
- **Authorized official phone:** (510) 893-8989

## Contact information

- **Practice address:** 1850 ALICE ST, OAKLAND, CA 94612-4175
- **Practice address phone:** (510) 835-5511
- **Practice address fax:** (510) 273-0529
- **Mailing address:** 201 19TH ST, SUITE 100, OAKLAND, CA 94612-4117
- **Mailing address phone:** (510) 893-8989
- **Mailing address fax:** (510) 893-3041

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 020000057 | CA | Yes |

## Other

- **Enumeration date:** 02/14/2006
- **Last updated:** 04/24/2014