Provider Demographics
NPI:1811038425
Name:HAYWARD CONVALESCENT LLC
Entity Type:Organization
Organization Name:HAYWARD CONVALESCENT LLC
Other - Org Name:HAYWARD CONVALESCENT HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:ARGABRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-538-3866
Mailing Address - Street 1:1832 B ST
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-3140
Mailing Address - Country:US
Mailing Address - Phone:510-538-3866
Mailing Address - Fax:510-733-3353
Practice Address - Street 1:1832 B ST
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-3140
Practice Address - Country:US
Practice Address - Phone:510-538-3866
Practice Address - Fax:510-733-3353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA02000041314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA055338Medicare ID - Type Unspecified