Organization
COVENANT CARE CALIFORNIA INC
Active
Other names
Vintage Faire Nursing and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN P MORGAN (ADMINISTRATOR)
(209) 521-2094
Entity
Organization
Contact information
Practice address
3620B DALE RD, MODESTO, CA 95356-0500
(209) 521-2094
(209) 521-6180
Mailing address
3620B DALE RD, MODESTO, CA 95356-0500
(209) 521-2094
(209) 521-6180
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
55355H
—
CA
Enumeration date
10/05/2005
Last updated
08/22/2020
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