Organization
SHATTUCK HEALTHCARE INC. DBA ELMWOOD NURSING AND REHABILITATION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LUZVIMINDA G LUKBAN (ADMINISTRATOR)
(510) 665-2800
Entity
Organization
Contact information
Practice address
2829 SHATTUCK AVE, BERKELEY, CA 94705-1037
(510) 665-2800
(510) 665-2808
Mailing address
2829 SHATTUCK AVE, BERKELEY, CA 94705-1037
(510) 665-2800
(510) 665-2808
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC55819F
—
CA
Enumeration date
08/05/2006
Last updated
08/22/2020
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