7TH AVENUE CENTER, LLC
Intermediate Care Facility, Mental Illness
Santa Cruz, California
Provider NPI: 1629132089
Organization Information:Organization Name: 7TH AVENUE CENTER, LLC
Practice Location:
1171 7TH AVE SANTA CRUZ, CA 95062 US
Tel: 831-420-0120 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
1171 7TH AVE SANTA CRUZ, CA 95062 US
Tel: 831-420-0120 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 310500000X | Nursing & Custodial Care Facilities Intermediate Care Facility, Mental Illness | CA |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
MEDI-CAL PRV NBR | 44B7 | CA | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin