Organization · Type 2 NPI

Chancellor Health Care of California Iv, Inc.

Assisted Living Facility · Baltimore, MD

NPI number 1982035606 Active

Practice location

1320 Windlass Dr
Baltimore, MD 21220-4100

Call (410) 918-2139 Map

Fax (410) 687-9909

Mailing address

115 Johnson St
Windsor, CA 95492-7435

Specialties and licenses

Taxonomy	Code	License
Assisted Living Facility Primary	310400000X	None listed

Assisted Living Facility: A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

Another provider at this address

Diane A. Vestal, OTA/LOccupational Therapy Assistant Baltimore, MD NPI 1417312489

Other assisted living facility providers in Baltimore

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NPI record

NPI: 1982035606
Entity type: Organization (Type 2)
Issued: Dec 5, 2013
Last updated: Dec 5, 2013
Status: Active
Subpart: Yes of Chancellor Health Care, Inc.

Other names

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The Woodlands Assisted Living · doing business as

Authorized official

Cluney Stagg
Chief Financial Officer
(707) 687-1919

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1982035606

Chancellor Health Care of California Iv, Inc.'s National Provider Identifier is 1982035606, issued on Dec 5, 2013. The primary taxonomy on file is Assisted Living Facility (310400000X), and the practice location is in Baltimore, MD. The record was last updated on Dec 5, 2013.