Provider Demographics
NPI:1497802078
Name:ORCHARD HOSPITAL
Entity Type:Organization
Organization Name:ORCHARD HOSPITAL
Other - Org Name:ORCHARD HOSPITAL D/P SNF
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:STARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-846-9001
Mailing Address - Street 1:PO BOX 97
Mailing Address - Street 2:
Mailing Address - City:GRIDLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95948-0097
Mailing Address - Country:US
Mailing Address - Phone:530-846-9000
Mailing Address - Fax:530-846-9027
Practice Address - Street 1:240 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:GRIDLEY
Practice Address - State:CA
Practice Address - Zip Code:95948-2216
Practice Address - Country:US
Practice Address - Phone:530-846-9000
Practice Address - Fax:530-846-9027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA230000007314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALTC90056FMedicaid
CA555776OtherMEDICARE ID - TYPE UNSPECIFIED