Organization
MANOR CARE TICE VALLEY CA LLC
Active
Other names
ProMedica Skilled Nursing and Rehabilitation (Tice Valley)
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTIN D ALLEN (DIRECTOR)
(419) 252-5734
Entity
Organization
Contact information
Practice address
1975 TICE VALLEY BLVD, WALNUT CREEK, CA 94595-2201
(925) 906-0200
(925) 906-0201
Mailing address
333 N SUMMIT ST, TOLEDO, OH 43604-2615
(419) 252-5500
(877) 385-9446
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
140000554
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609817352
—
CA
Enumeration date
06/10/2006
Last updated
12/16/2022
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