Provider Demographics
NPI:1235607045
Name:HCP SANTA ROSA CA OPCO, LLC
Entity Type:Organization
Organization Name:HCP SANTA ROSA CA OPCO, LLC
Other - Org Name:ARBOL RESIDENCES OF SANTA ROSA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GILBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:CARRASCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-453-7425
Mailing Address - Street 1:300 FOUNTAINGROVE PKWY
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-5720
Mailing Address - Country:US
Mailing Address - Phone:707-566-8600
Mailing Address - Fax:707-566-7936
Practice Address - Street 1:300 FOUNTAINGROVE PKWY
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-5720
Practice Address - Country:US
Practice Address - Phone:707-566-8600
Practice Address - Fax:707-566-7936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-09
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility