FAIR OAKS RESIDENTIAL TREATMENT FACILITY LLC NPI 1114679305

NPI Information

FAIR OAKS RESIDENTIAL TREATMENT FACILITY, LLC is a nursing care in Hayward, CA. The provider is a Nursing Care Agency is an entity that provides skilled nursing care through the services of a Registered Nurse (RN) or a Licensed Practical Nurse (LPN), by employees, contracted individuals, or via a registry, in a variety of settings. The agency may engage in providing private duty nursing and/or staffing services. FAIR OAKS RESIDENTIAL TREATMENT FACILITY, LLC NPI is 1114679305. The provider is registered as an organization entity type.

The provider's business location address is:

1782 B ST
HAYWARD, CA
ZIP 94541-102
Phone: (916) 458-4100

The provider's authorized official is Alex Rudakov .
The authorized official title is Secretary and has the following contact phone number (415) 812-2955.

The CLIA number assigned to this NPI record is 05D2297196 - other - psychiatric residential with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/19/2022 and was last updated on 1/19/2022.

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:

Other Identifiers

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.