Provider Demographics
NPI:1568719813
Name:PENN VALLEY SEVENTH-DAY ADVENTIST CHURCH
Entity Type:Organization
Organization Name:PENN VALLEY SEVENTH-DAY ADVENTIST CHURCH
Other - Org Name:HELPING HANDS CAREGIVER RESOURCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR PROPERTY & RISK MANAGEMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGNUSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:925-685-4300
Mailing Address - Street 1:PO BOX 23165
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-0165
Mailing Address - Country:US
Mailing Address - Phone:925-685-4300
Mailing Address - Fax:925-685-4380
Practice Address - Street 1:17645 PENN VALLEY DR
Practice Address - Street 2:
Practice Address - City:PENN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95946-9998
Practice Address - Country:US
Practice Address - Phone:530-432-2540
Practice Address - Fax:530-432-2479
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHERN CALIFORNIA CONFERENCE OF SEVENTH-DAY ADVENTISTS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA297004181261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA297004181OtherCALIFORNIA DEPARTMENT OF SOCIAL SERVICES ADC PROVIDER