Provider Demographics
NPI:1114922614
Name:ESKATON PROPERTIES, INCORPORATED
Entity Type:Organization
Organization Name:ESKATON PROPERTIES, INCORPORATED
Other - Org Name:ESKATON CARE CENTER GREENHAVEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-334-0810
Mailing Address - Street 1:5105 MANZANITA AVE
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-0523
Mailing Address - Country:US
Mailing Address - Phone:916-334-0810
Mailing Address - Fax:916-338-1248
Practice Address - Street 1:455 FLORIN RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-2024
Practice Address - Country:US
Practice Address - Phone:916-393-2550
Practice Address - Fax:916-393-1706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-20
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA030000158314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALTC55098FMedicaid
CALTC55098FMedicaid