Organization
GRANCARE LLC
Active
Other names
Creekside Healthcare Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANDREA SAAVEDRA (DIRECTOR OF ACCOUNTS RECEIVABLE)
(707) 208-1940
Entity
Organization
Contact information
Practice address
1900 CHURCH LN, SAN PABLO, CA 94806-3708
(510) 235-5514
Mailing address
1900 CHURCH LN, SAN PABLO, CA 94806-3708
(510) 235-5514
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
314000000
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC05099I
—
CA
Enumeration date
02/07/2006
Last updated
09/10/2013
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