Provider Demographics
NPI:1871269522
Name:SHERWOOD OAKS POST ACUTE CARE LLC
Entity Type:Organization
Organization Name:SHERWOOD OAKS POST ACUTE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:QING
Authorized Official - Middle Name:
Authorized Official - Last Name:XIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-962-8298
Mailing Address - Street 1:130 DANA ST
Mailing Address - Street 2:
Mailing Address - City:FORT BRAGG
Mailing Address - State:CA
Mailing Address - Zip Code:95437-4506
Mailing Address - Country:US
Mailing Address - Phone:707-964-6333
Mailing Address - Fax:
Practice Address - Street 1:130 DANA ST
Practice Address - Street 2:
Practice Address - City:FORT BRAGG
Practice Address - State:CA
Practice Address - Zip Code:95437-4506
Practice Address - Country:US
Practice Address - Phone:707-964-6333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-20
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility