Provider Demographics
NPI:1497763528
Name:ALAIDANDREW CORPORATION
Entity Type:Organization
Organization Name:ALAIDANDREW CORPORATION
Other - Org Name:VALLEY CONVALESCENT HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ETCHEVERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-334-2200
Mailing Address - Street 1:1205 8TH ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93304-2123
Mailing Address - Country:US
Mailing Address - Phone:661-334-2200
Mailing Address - Fax:661-334-2212
Practice Address - Street 1:1205 8TH ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93304-2123
Practice Address - Country:US
Practice Address - Phone:661-334-2200
Practice Address - Fax:661-334-2212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALTC55229HMedicaid
CALTC55229HMedicaid
CA4114840001Medicare NSC