# COVENANT CARE OF CALIFORNIA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pacific Gardens Nursing and Rehabilitation Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972576643
- **Authorized official:** MR. BART J VANDERWAL (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (559) 251-8463

## Contact information

- **Practice address:** 577 S PEACH AVE, FRESNO, CA 93727-3952
- **Practice address phone:** (559) 251-8463
- **Practice address fax:** (559) 251-4465
- **Mailing address:** 577 S PEACH AVE, FRESNO, CA 93727-3952
- **Mailing address phone:** (559) 251-8463
- **Mailing address fax:** (559) 251-4465

## Taxonomy

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

## Other

- **Enumeration date:** 02/10/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZZR06207J | — | CA |