Fair Oaks Residential Treatment Facility, Llc

LBN: Fair Oaks Residential Treatment Facility, Llc
Fair Oaks Residential Treatment Facility, Llc is an health care organization with primary practice located at 1782 B St , Hayward CA 94541-3102. The organization recently has only one registered license in Agencies / Nursing Care, which is considered as the primary health care specialty. Fair Oaks Residential Treatment Facility, Llc can be contacted via phone (916) 458-4100, or through Rudakov, Alex via phone (415) 812-2955.

Contact Information

Primary practice address
1782 B St Hayward CA 94541-3102
Phone: (916) 458-4100
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Rudakov, Alex
Phone: (415) 812-2955

Health care specialties

SpecialtyCodeLicense #State
Agencies / Nursing Care 251J00000X

Profile Details

NPI number 1114679305
LBN Legal business name Fair Oaks Residential Treatment Facility, Llc
DBA Doing business as
Authorized official Rudakov, Alex
Entity Organization
Organization subpart 1 No
Enumeration date Jan 19th, 2022
Last updated Jan 19th, 2022 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114679305 NPPES
California MEDICAID 2880

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