Provider Demographics
NPI:1417152570
Name:NOVATO HEALTHCARE CENTER, LLC
Entity Type:Organization
Organization Name:NOVATO HEALTHCARE CENTER, LLC
Other - Org Name:NOVATO HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHLOMO
Authorized Official - Middle Name:
Authorized Official - Last Name:RECHNITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-800-1191
Mailing Address - Street 1:1565 HILL RD
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94947-4063
Mailing Address - Country:US
Mailing Address - Phone:323-634-1940
Mailing Address - Fax:323-634-1943
Practice Address - Street 1:1565 HILL RD
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94947-4063
Practice Address - Country:US
Practice Address - Phone:415-897-6161
Practice Address - Fax:415-898-0561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALTC90087FMedicaid
CALTC90087FMedicaid