- Enrollment id
- O20061222000290
- Enrollment state
- CA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1952465791
- Multiple npi flag
- N
- Ccn
- 555316
- Associate id
- 1153321120
- Organization name
- APPLEWOOD OPERATING COMPANY LLC
- Doing business as name
- COPPER RIDGE CARE CENTER
- Incorporation date
- 2006-10-23
- Incorporation state
- NV
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- COPPER RIDGE CARE CENTER
- Affiliation entity name
- PACS GROUP
- Affiliation entity id
- 690
- Address line 1
- 201 HARTNELL AVE
- City
- REDDING
- State
- CA
- Zip code
- 960021843