Provider Demographics
NPI:1225554645
Name:GHC OF CONTRA COSTA, LLC
Entity Type:Organization
Organization Name:GHC OF CONTRA COSTA, LLC
Other - Org Name:BAYBERRY NURSING & REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:IS AND AR TRAINING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROBYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:WELLBORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-315-0984
Mailing Address - Street 1:6 HUTTON CENTRE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92707-8762
Mailing Address - Country:US
Mailing Address - Phone:714-241-5600
Mailing Address - Fax:
Practice Address - Street 1:1800 ADOBE ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2313
Practice Address - Country:US
Practice Address - Phone:925-825-1300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-17
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility