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GARDENSIDE ELDERCARE LLC NPI 1063791713


NPI Information

NPI: 1063791713
Provider Name: GARDENSIDE ELDERCARE, LLC
Classification: Residential Treatment Facility, Physical Disabilities - 320700000X
Entity Type: Organization
Address:
529 9TH STREET
FORTUNA, CA
ZIP 95540
Phone: (707) 725-7873
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GARDENSIDE ELDERCARE, LLC is a residential treatment facility physical disabilities in Fortuna, CA. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently. GARDENSIDE ELDERCARE, LLC NPI is 1063791713. The provider is registered as an organization entity type.

The provider's business location address is:

529 9TH STREET
FORTUNA, CA
ZIP 95540
Phone: (707) 725-7873
Fax: (707) 215-7036

The provider's authorized official is Trina Keller .
The authorized official title is Member and has the following contact phone number (707) 725-7873.

The enumeration date for this NPI number is 8/12/2011 and was last updated on 8/12/2011.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1320700000XResidential Treatment Facility, Physical Disabilities126802046CALIFORNIAYes

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: 5/5/2024

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