Provider Demographics
NPI:1619966751
Name:ST FRANCIS EXTENDED CARE INC
Entity Type:Organization
Organization Name:ST FRANCIS EXTENDED CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:RAPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-782-3825
Mailing Address - Street 1:718 BARTLETT AVE
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-3698
Mailing Address - Country:US
Mailing Address - Phone:510-782-3825
Mailing Address - Fax:510-782-8793
Practice Address - Street 1:718 BARTLETT AVE
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-3698
Practice Address - Country:US
Practice Address - Phone:510-785-3630
Practice Address - Fax:510-785-5705
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SR ADMINISTRATIVE SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-10-20
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZR05803GMedicaid
CA555418Medicare Oscar/Certification