Organization
PEAHI BAY, LLC
Active
Other names
River View Post Acute
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN WILLIAMS (MANAGING MEMBER)
(916) 945-1248
Entity
Organization
Contact information
Practice address
1611 SCENIC DR, MODESTO, CA 95355-4907
(209) 523-5667
Mailing address
599 MENLO DR, ROCKLIN, CA 95765-3725
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100000028
—
CA
Enumeration date
03/23/2022
Last updated
03/23/2022
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