Brentwood Skilled Nursing Center, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

230000043 Issued in CA

Legal business name

BRENTWOOD SKILLED NURSING CENTER, INC.

Doing business as

Brentwood Skilled Nursing & Rehabilitation Center

Practice address

1795 Walnut St
Red Bluff, CA 96080-3645

Phone

(530) 527-2046

Fax

(530) 527-8737

NPI assigned

Aug 3, 2005

Last updated

Nov 20, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Terry Bane

Title

President

Phone

(530) 897-5100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Brentwood Skilled Nursing & Rehabilitation Center Doing business as

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384905600000",
    "number": "1861493504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1795 WALNUT ST",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960803645",
            "telephone_number": "530-527-2046",
            "fax_number": "530-527-8737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1795 WALNUT ST",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960803645",
            "telephone_number": "530-527-2046",
            "fax_number": "530-527-8737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENTWOOD SKILLED NURSING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-03",
        "last_updated": "2013-11-20",
        "status": "A",
        "authorized_official_last_name": "BANE",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "530-897-5100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "230000043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZR05489H",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brentwood Skilled Nursing & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Karen A Borm, RN
• Richard Lee Bradley
• Bianca Bradshaw, PHARM.D.
• Ashley Brashear, LVN II
• Brentwood Post Acute LLC (Brentwood Post Acute)
• Melody Brewer, MSW
• Jennifer L Brinkerhoff
• Bailey Michelle Britt
• Carson James Brown
• Michaele Marie Brown, LCSW

• Skilled Nursing Facility in Red Bluff, CA
• Providers in Red Bluff, 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 Nov 20, 2013; 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.