Provider Demographics
NPI:1518032150
Name:RED BLUFF HEALTH CARE, INC.
Entity Type:Organization
Organization Name:RED BLUFF HEALTH CARE, INC.
Other - Org Name:RED BLUFF HEALTH CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAT
Authorized Official - Middle Name:
Authorized Official - Last Name:PODDATOORI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-677-3566
Mailing Address - Street 1:555 LUTHER RD
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-4256
Mailing Address - Country:US
Mailing Address - Phone:530-527-6232
Mailing Address - Fax:530-527-6848
Practice Address - Street 1:555 LUTHER RD
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-4256
Practice Address - Country:US
Practice Address - Phone:530-527-6232
Practice Address - Fax:530-527-6846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2010-05-12
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
CA056274Medicare Oscar/Certification