Organization
SOUTHERN HUMBOLDT COMMUNITY HEALTHCARE DISTRICT
Active
Other names
Jerold Phelps Community Hospital Skilled Nursing Facility
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW E REES (ADMINISTRATOR)
(707) 923-3921
Entity
Organization
Contact information
Practice address
733 CEDAR ST, GARBERVILLE, CA 95542-3201
(707) 923-3921
(707) 923-1456
Mailing address
733 CEDAR ST, GARBERVILLE, CA 95542-3201
(707) 923-3921
(707) 923-1456
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
110000052
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
174988
—
AZ
05
—
272260
—
OR
05
—
3003993
—
WA
01
—
LTC55516F
MEDI-CAL SNF
CA
01
—
ZZZJ1202Z
BLUE SHIELD (HOSPITAL)
CA
Enumeration date
04/23/2007
Last updated
01/18/2022
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