Organization
COVENANT CARE CALIFORNIA, LLC
Active
Other names
Palo Alto Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL SPARKS (DIRECTOR OF REIMBURSEMENT)
(949) 349-1200
Entity
Organization
Contact information
Practice address
911 BRYANT STREET, PALO ALTO, CA 94301-2711
(650) 327-0511
(650) 327-7823
Mailing address
911 BRYANT STREET, PALO ALTO, CA 94301-2711
(650) 327-0511
(650) 327-7823
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
220000425
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
206431059
OSHPD
CA
05
—
ZZR05646J
—
CA
Enumeration date
02/23/2007
Last updated
09/25/2013
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