Organization
EDEN VALLEY CARE CENTER
Active
Other names
EDEN VALLEY CARE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
IDA LOPEZ CHAN (CHIEF EXECUTIVE OFFICER)
(831) 678-2462
Entity
Organization
Contact information
Practice address
612 MAIN STREET, SOLEDAD, CA 93960-2533
(831) 678-2462
Mailing address
612 MAIN ST, SOLEDAD, CA 93960-2533
(831) 678-2462
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
070000327
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC55538F
—
CA
Enumeration date
04/06/2007
Last updated
06/28/2021
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