Provider Demographics
NPI:1669462057
Name:YUBA CITY NURSING & REHAB LLC
Entity Type:Organization
Organization Name:YUBA CITY NURSING & REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LVN/MDS
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:530-671-0550
Mailing Address - Street 1:1220 PLUMAS ST
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-3411
Mailing Address - Country:US
Mailing Address - Phone:530-671-0550
Mailing Address - Fax:530-671-6384
Practice Address - Street 1:1220 PLUMAS ST
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-3411
Practice Address - Country:US
Practice Address - Phone:530-671-0550
Practice Address - Fax:530-671-6384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2300000000000001293140N1450X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric