St. Luke Healthcare and Rehabilitation Center

Organization Active NPI Skilled Nursing Facility · Fortuna, CA

NPI 1770570319 · NPPES record last updated Jul 17, 2007

Key facts

NPI
1770570319
Entity type
Organization (NPI type 2)
Primary specialty
Skilled Nursing Facility 314000000X
Legal business name
ST. LUKE HEALTHCARE AND REHABILITATION CENTER
Practice address
2321 Newburg Rd
Fortuna, CA 95540-2815
Phone
(707) 725-4467
Fax
(707) 725-1848
NPI assigned
Sep 29, 2005
Organization subpart
No

Authorized official

Name
Ms. Lorena A Smith, LNHA
Title
Administrator
Phone
(707) 725-4467

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X CA Yes

Addresses

Primary practice location

2321 Newburg Rd
Fortuna, CA 95540-2815

Mailing address

2321 Newburg Rd
Fortuna, CA 95540-2815
Phone (707) 725-4467

Other identifiers

IdentifierTypeStateIssuer
ZZR06361GMedicaidCA

Other providers in Fortuna, CA

All providers in Fortuna, CA · Skilled Nursing Facility in California

Sources for this page

Verify at the official NPI Registry.