Gardenside Eldercare, Llc

NPI 1063791713 - Residential Treatment Facility, Physical Disabilities - 320700000X

NPI Details
NPI 1063791713
Enumeration Date 08/12/2011
Last Updated 08/12/2011
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name TRINA TRINA
Position MEMBER
Phone (707) 725-7873
Fax (707) 215-7036
Practice Location
529 9TH STREET
FORTUNA CA, 95540, US
Phone (707) 725-7873
Fax (707) 215-7036
Business Location
1095 S FORTUNA BLVD STE F
FORTUNA CA, 95540-3067, US
Phone (707) 725-7873
Fax (707) 215-7036
Toxanomy
Taxonomy Code 320700000X
License State California
License Number 126802046
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According to our database, Gardenside Eldercare, Llc NPI is 1063791713, taxonomy code is 320700000X and license number is 126802046, license state is located at California. Gardenside Eldercare, Llc physically located at 529 9th Street, Fortuna CA, 95540. NPI Number 1033115704 has the healthcare provider type.

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1063791713 NPI number is provided on an as is basis without warranty of any kind. 1063791713 is maintained by the National Plan & Provider Enumeration System. The contents of Gardenside Eldercare, Llc are for informational purposes only.