Organization
COUNTY OF SACRAMENTO
Active
Other names
CCS Bowling Green MTU
Organization subpart
No
Provider details
NPI number
Authorized official
BERNICE WALTON (DIVISION CHIEF)
(916) 875-6086
Entity
Organization
Contact information
Practice address
4211 TURNBRIDGE DR, SACRAMENTO, CA 95823-1929
(916) 392-1480
(916) 393-6079
Mailing address
7001A EAST PKWY, SUITE 600, SACRAMENTO, CA 95823-2501
(916) 875-5881
(916) 875-5888
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CCS00025F
—
CA
Enumeration date
11/13/2006
Last updated
08/22/2020
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