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SUMMERVILLE AT COBBCO INC. NPI 1578892980


NPI Information

NPI: 1578892980
Provider Name: SUMMERVILLE AT COBBCO, INC.

Doing Business As: BROOKDALE SAN PABLO

Classification: Custodial Care Facility - 311ZA0620X
Entity Type: Organization

Specialization: Adult Care Home

Address:
13956 SAN PABLO AVE
SAN PABLO, CA
ZIP 94806
Phone: (510) 236-1444
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SUMMERVILLE AT COBBCO, INC. is an adult care home custodial care facility in San Pablo, CA. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. SUMMERVILLE AT COBBCO, INC. NPI is 1578892980. The provider is registered as an organization entity type.
The provider Is Doing Business As Brookdale San Pablo.

The provider's business location address is:

13956 SAN PABLO AVE
SAN PABLO, CA
ZIP 94806-313
Phone: (510) 236-1444

The provider's authorized official is Bryan Richardson .
The authorized official title is Evp, Chief Admin. Officer and has the following contact phone number (615) 564-8131.

The enumeration date for this NPI number is 12/14/2009 and was last updated on 5/12/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1311ZA0620XCustodial Care FacilityAdult Care Home075600298CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1=========OTHERCALIFORNIAPACE - CENTERS FOR ELDERS INDEPENDENCE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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