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Organization
GRANCARE LLC
Active
Organization
GRANCARE LLC
Active
Other names
Creekside Healthcare Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANDREA SAAVEDRA (DIRECTOR OF ACCOUNTS RECEIVABLE)
(707) 208-1940
Entity
Organization
Contact information
Practice address
1900 CHURCH LN, SAN PABLO, CA 94806-3708
(510) 235-5514
Mailing address
1900 CHURCH LN, SAN PABLO, CA 94806-3708
(510) 235-5514
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
314000000
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC05099I
—
CA
Enumeration date
02/07/2006
Last updated
09/10/2013
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