- Enrollment id
- O20090323000232
- Enrollment state
- CA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1841295003
- Multiple npi flag
- N
- Ccn
- 555767
- Associate id
- 4183781966
- Organization name
- BELLAKEN HEALTH GROUP, INC.
- Doing business as name
- BELLAKEN SKILLED NURSING CENTER
- Incorporation date
- 2007-07-30
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Nursing home provider name
- BELLAKEN SKILLED NURSING CENTER
- Address line 1
- 2780 26TH AVENUE
- City
- OAKLAND
- State
- CA
- Zip code
- 946011911