DEGROOT NURSING HOME NPI 1346386620

NPI Information

NPI: 1346386620
Provider Name: DEGROOT NURSING HOME
Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization
Address:
1015 BUCHON ST
SAN LUIS OBISPO, CA
ZIP 93401
Phone: (805) 543-7663
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DEGROOT NURSING HOME is an intermediate care facility mentally retarded in San Luis Obispo, CA. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. DEGROOT NURSING HOME NPI is 1346386620. The provider is registered as an organization entity type.

The provider's business location address is:

1015 BUCHON ST
SAN LUIS OBISPO, CA
ZIP 93401-021
Phone: (805) 543-7663
Fax: (805) 544-7967

The provider's authorized official is Adriaantje Sjany De Groot .
The authorized official title is Administrator and has the following contact phone number (805) 543-7663.

The enumeration date for this NPI number is 1/30/2007 and was last updated on 8/22/2020.

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
1	315P00000X	Intermediate Care Facility, Intellectual Disabilities			CALIFORNIA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	LTC80007F	OTHER	CALIFORNIA	MEDI-CAL ID NUMBER

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: 4/28/2024

NPI Synchronization or Removal

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