Provider Demographics
NPI:1427688639
Name:SHAFTER NURSING REHAB LLC
Entity type:Organization
Organization Name:SHAFTER NURSING REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUSH
Authorized Official - Middle Name:
Authorized Official - Last Name:MELLITI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-800-8128
Mailing Address - Street 1:5509 MUIRFIELD DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93306-9516
Mailing Address - Country:US
Mailing Address - Phone:661-800-8128
Mailing Address - Fax:
Practice Address - Street 1:140 E TULARE AVE
Practice Address - Street 2:
Practice Address - City:SHAFTER
Practice Address - State:CA
Practice Address - Zip Code:93263-1834
Practice Address - Country:US
Practice Address - Phone:661-746-3912
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-16
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility