Organization
WILLOW CREEK HEALTHCARE CENTER, LLC
Active
Parent organization
SUMMIT CARE LLC
Other names
Willow Creek Healthcare Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUMMIT CARE LLC
Authorized official
MICHAEL T. BERG (ASSISTANT SECRETARY)
(505) 468-4752
Entity
Organization
Contact information
Practice address
650 W ALLUVIAL AVE, CLOVIS, CA 93611-6716
(559) 323-6200
(559) 323-4665
Mailing address
650 W ALLUVIAL AVE, CLOVIS, CA 93611-6716
(559) 323-6200
(559) 323-4665
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
040000418
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC55652G
—
CA
Enumeration date
05/24/2006
Last updated
02/01/2016
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