Provider Demographics
NPI:1922332162
Name:HCRC,INC
Entity Type:Organization
Organization Name:HCRC,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT/SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:PREMA
Authorized Official - Middle Name:P
Authorized Official - Last Name:THEKKEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-457-1150
Mailing Address - Street 1:540 W MONTE VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-3620
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-21
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA020000041314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility