Redwod Shore Empire, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

REDWOD SHORE EMPIRE, LLC

Doing business as

Redwood Empire Nursing & Rehabilitation Center

Practice address

131 Whitmore LN
Ukiah, CA 95482-6931

Phone

(209) 576-5725

NPI assigned

Feb 7, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Thresiamma J Pallivathucal, RN

Title

Owner

Phone

(209) 576-5725

Specialties & licenses 1

Addresses

Other names 1

• Redwood Empire Nursing & Rehabilitation Center Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202342400000",
    "number": "1710165162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3141 ELYSE CT",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953558692",
            "telephone_number": "209-576-5725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 WHITMORE LN",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954826931",
            "telephone_number": "209-576-5725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDWOD SHORE EMPIRE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-07",
        "last_updated": "2008-02-07",
        "status": "A",
        "authorized_official_last_name": "PALLIVATHUCAL",
        "authorized_official_first_name": "THRESIAMMA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-576-5725",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Redwood Empire Nursing & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Ukiah, CA
• Providers in Ukiah, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.