Provider Demographics
NPI:1275797409
Name:LTP GENERATIONS LLC
Entity Type:Organization
Organization Name:LTP GENERATIONS LLC
Other - Org Name:OAKGROVE SPRINGS CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LETICIA
Authorized Official - Middle Name:PANIS
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:925-837-7068
Mailing Address - Street 1:PO BOX 1297
Mailing Address - Street 2:
Mailing Address - City:ALAMO
Mailing Address - State:CA
Mailing Address - Zip Code:94507-7297
Mailing Address - Country:US
Mailing Address - Phone:510-836-3777
Mailing Address - Fax:510-836-0516
Practice Address - Street 1:309 MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94610-3233
Practice Address - Country:US
Practice Address - Phone:510-836-3777
Practice Address - Fax:510-836-0516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA056350Medicare Oscar/Certification