Country Club Manor

LBN: Country Club Manor
Country Club Manor is an health care organization with primary practice located at 2100 Butano Dr , Sacramento CA 95825-0448. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Assisted Living Facility, which is considered as the primary health care specialty. Country Club Manor can be contacted via phone (916) 481-9240, or through Drake, Stuart M via phone (916) 481-9240.

Contact Information

Primary practice address
2100 Butano Dr Sacramento CA 95825-0448
Phone: (916) 481-9240
Fax: (916) 483-7134
Website:
Map and Directions
Authorized official contact:
Name: Drake, Stuart M
Phone: (916) 481-9240

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X California

Profile Details

NPI number 1033259213
LBN Legal business name Country Club Manor
DBA Doing business as
Authorized official Drake, Stuart M
Entity Organization
Organization subpart 1 No
Enumeration date Feb 7th, 2007
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1033259213 NPPES
California MEDICAID RCF00022F

Popular Providers