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ASHLEY LTC INC NPI 1487641049


NPI Information

NPI: 1487641049
Provider Name: ASHLEY LTC INC

Doing Business As: SANTA ROSA CONVALESCENT HOSPITAL

Classification: Skilled Nursing Facility - 314000000X
Entity Type: Organization

CLIA Number: 05D0611844

Address:
446 ARROWOOD DR
SANTA ROSA, CA
ZIP 95407
Phone: (707) 528-2100
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ASHLEY LTC INC is a skilled nursing facility in Santa Rosa, CA. The provider is (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. ASHLEY LTC INC NPI is 1487641049. The provider is registered as an organization entity type.
The provider Is Doing Business As Santa Rosa Convalescent Hospital.

The provider's business location address is:

446 ARROWOOD DR
SANTA ROSA, CA
ZIP 95407-503
Phone: (707) 528-2100
Fax: (707) 568-1209

The provider's authorized official is Frederick C Benson .
The authorized official title is Administrator and has the following contact phone number (707) 528-2100.

The CLIA number assigned to this NPI record is 05D0611844 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/29/2005 and was last updated on 12/26/2011.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1314000000XSkilled Nursing Facility01-0000064CALIFORNIAYes

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
105-6259MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA
2ZZR06259HMEDICAIDCALIFORNIA

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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