Provider Demographics
NPI:1831119049
Name:NORTHERN CALIFORNIA CONGREGATIONAL RETIREMENT HOMES, INC
Entity Type:Organization
Organization Name:NORTHERN CALIFORNIA CONGREGATIONAL RETIREMENT HOMES, INC
Other - Org Name:CARMEL VALLEY MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:ZIMMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-626-4707
Mailing Address - Street 1:8545 CARMEL VALLEY ROAD
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93923
Mailing Address - Country:US
Mailing Address - Phone:831-624-1281
Mailing Address - Fax:831-625-9827
Practice Address - Street 1:8545 CARMEL VALLEY ROAD
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:CA
Practice Address - Zip Code:93923
Practice Address - Country:US
Practice Address - Phone:831-624-1281
Practice Address - Fax:831-625-9827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Single Specialty
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing FacilityGroup - Single Specialty