# EDEN VALLEY CARE CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** EDEN VALLEY CARE CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669594867
- **Authorized official:** IDA LOPEZ CHAN (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (831) 678-2462

## Contact information

- **Practice address:** 612 MAIN STREET, SOLEDAD, CA 93960-2533
- **Practice address phone:** (831) 678-2462
- **Mailing address:** 612 MAIN ST, SOLEDAD, CA 93960-2533
- **Mailing address phone:** (831) 678-2462

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 070000327 | CA | Yes |

## Other

- **Enumeration date:** 04/06/2007
- **Last updated:** 06/28/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | LTC55538F | — | CA |