Organization
BERRYMAN HEALTH, INC
Active
Other names
Healdsburg Senior Living Community
Organization subpart
No
Provider details
NPI number
Authorized official
MS. FAYE LINCLON (V.P. POLICY AND GOVERNMENT RELATION)
(801) 325-0153
Entity
Organization
Contact information
Practice address
725 GROVE ST, HEALDSBURG, CA 95448-4756
(707) 433-4877
(707) 433-5974
Mailing address
255 E 400 S, SUITE 200, SALT LAKE CITY, UT 84111-2846
(801) 325-0153
(801) 596-9001
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
010000014
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC55820F
—
CA
Enumeration date
12/13/2006
Last updated
12/14/2007
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