Organization
STATE OF CALIFORNIA - DEPARTMENT OF DEVELOPMENTAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLA CASTANEDA (CHIEF DEPUTY DIRECTOR)
(916) 654-2282
Entity
Organization
Contact information
Practice address
15000 ARNOLD DRIVE, ELDRIDGE, CA 95431-1493
(707) 938-6000
(707) 938-6940
Mailing address
1215 O ST # MS 10-30, SACRAMENTO, CA 95814-5804
(916) 654-3463
(916) 653-4587
Taxonomy
Speciality
Code
Description
License number
State
282E00000X
Long Term Care Hospital
—
—
282N00000X
General Acute Care Hospital
Primary
10000089
CA
313M00000X
Nursing Facility/Intermediate Care Facility
10000089
CA
314000000X
Skilled Nursing Facility
10000089
CA
315P00000X
Intellectual Disabilities Intermediate Care Facility
10000089
CA
333600000X
Pharmacy
10000089
CA
3336L0003X
Long Term Care Pharmacy
HPE19573
CA
Other
Enumeration date
05/18/2006
Last updated
01/24/2022
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