WEST SACRAMENTO NURSING AND REHABILITATION CENTER
NPI 1104316413
Skilled Nursing Facility in West Sacramento, CA
- Organization
- Skilled Nursing Facility
- CLIA Number: 05D2181017
- CLIA Cert. Type: Other - CLHF
- CLIA Exp. Date: 03-24-2028
About WEST SACRAMENTO NURSING AND REHABILITATION CENTER
This page provides the complete NPI Profile along with additional information for West Sacramento Nursing And Rehabilitation Center, a provider established in West Sacramento, California operating as a Skilled Nursing Facility. The healthcare provider is registered in the NPI registry with number 1104316413 assigned on May 2018. The practitioner's primary taxonomy code is 314000000X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The provider's is doing business as West Sacramento Nursing And Rehabilitation Center. The authorized official of this NPI record is Mr. David Manukyan (Administrator)
- NPI
- 1104316413 Verify this NPI
- Provider Legal Name
- WEST SACRAMENTO NURSING AND REHABILITATION CENTER
- Other Organization Name
- WEST SACRAMENTO NURSING AND REHABILITATION CENTER
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 751 ELM STREET WEST SACRAMENTO, CA 95605
- Location Phone
- (530) 902-4142
- Mailing Address
- 751 ELM STREET WEST SACRAMENTO, CA 95605
- Mailing Phone
- (916) 572-0085
- Mailing Fax
- (916) 572-0333
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-11-2018
- Last Update Date
- 09-13-2021
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Skilled Nursing Facility
- Taxonomy Code
- 314000000X
- Type
- Nursing & Custodial Care Facilities
- Taxonomy Description
- (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 313M00000X | Nursing & Custodial Care Facilities | Nursing Facility/Intermediate Care Facility | (CA) |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D2181017
- Facility Type
- Other - CLHF
- Certificate Effective Date
- March 25, 2026
- Certificate Expiration Date
- March 24, 2028
- Laboratory Director
- ALEXANDER CHAN MD
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to West Sacramento Nursing And Rehabilitation Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1104316413, enumerated as an "organization" on May 11, 2018.
The provider is located at 751 ELM STREET WEST SACRAMENTO, CA 95605 and the phone number is (530) 902-4142.
Skilled Nursing Facility with taxonomy code 314000000X.
