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Organization
EDEN VALLEY CARE CENTER
Active
Organization
EDEN VALLEY CARE CENTER
Active
Other names
EDEN VALLEY CARE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
IDA LOPEZ CHAN (CHIEF EXECUTIVE OFFICER)
(831) 678-2462
Entity
Organization
Contact information
Practice address
612 MAIN STREET, SOLEDAD, CA 93960-2533
(831) 678-2462
Mailing address
612 MAIN ST, SOLEDAD, CA 93960-2533
(831) 678-2462
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
070000327
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC55538F
—
CA
Enumeration date
04/06/2007
Last updated
06/28/2021
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