Provider Demographics
NPI:1851602510
Name:CHATEAU AT CARMICHAEL PARK LLC
Entity Type:Organization
Organization Name:CHATEAU AT CARMICHAEL PARK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:M
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-485-1441
Mailing Address - Street 1:610 FULTON AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-4867
Mailing Address - Country:US
Mailing Address - Phone:916-485-1441
Mailing Address - Fax:916-485-1981
Practice Address - Street 1:7125 FAIR OAKS BLVD
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-6450
Practice Address - Country:US
Practice Address - Phone:916-481-7105
Practice Address - Fax:916-481-1242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-28
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA347001523310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility