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LAKE OROVILLE COUNTRY RETIREMENT NPI 1417939125


NPI Information

NPI: 1417939125
Provider Name: LAKE OROVILLE COUNTRY RETIREMENT

Doing Business As: COUNTRY CREST

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
55 CONCORDIA LN
OROVILLE, CA
ZIP 95966
Phone: (530) 533-7857
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LAKE OROVILLE COUNTRY RETIREMENT is an assisted living facility in Oroville, CA. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. LAKE OROVILLE COUNTRY RETIREMENT NPI is 1417939125. The provider is registered as an organization entity type.
The provider Is Doing Business As Country Crest.

The provider's business location address is:

55 CONCORDIA LN
OROVILLE, CA
ZIP 95966-347
Phone: (530) 533-7857
Fax: (530) 533-7887

The provider's authorized official is Larry Eugene Bradley .
The authorized official title is Executive Director and has the following contact phone number (530) 533-7857.

The enumeration date for this NPI number is 11/17/2005 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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1310400000XAssisted Living Facility45001619CALIFORNIAYes
2314000000XSkilled Nursing FacilityCALIFORNIAX

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
1LTC55802FMEDICAIDCALIFORNIA

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

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