Organization
COVENANT CARE CALIFORNIA, LLC
Active
Other names
Wagner Heights Nursing & Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL SPARKS (DIRECTOR OF REIMBURSEMENT)
(949) 349-1200
Entity
Organization
Contact information
Practice address
9289 BRANSTETTER PLACE, STOCKTON, CA 95209-1700
(209) 477-5252
(209) 474-0569
Mailing address
9289 BRANSTETTER PLACE, STOCKTON, CA 95209-1700
(209) 477-5252
(209) 474-0569
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
100000355
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
206394006
OSHPD
CA
05
—
LTC55332H
—
CA
Enumeration date
02/13/2007
Last updated
10/18/2013
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