Provider Demographics
NPI:1639506371
Name:SAN RAFAEL CARE CENTER, INC.
Entity Type:Organization
Organization Name:SAN RAFAEL CARE CENTER, INC.
Other - Org Name:SAN RAFAEL CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:PREIMESBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-855-0881
Mailing Address - Street 1:40 PROFESSIONAL CENTER PKWY
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-2703
Mailing Address - Country:US
Mailing Address - Phone:415-479-1230
Mailing Address - Fax:415-492-0398
Practice Address - Street 1:40 PROFESSIONAL CENTER PKWY
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-2703
Practice Address - Country:US
Practice Address - Phone:415-479-1230
Practice Address - Fax:415-492-0398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-26
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility