BROADWAY VILLA POST ACUTE is a certified and licensed healthcare facility located in 1250 BROADWAY, SONOMA, CA, 95476. The California Department of Public Health facility license number is 010000158. The facility started participation in Center for Medicare and Medicaid Services (CMS) in 1974-07-01 and its participation was approved in 2024-02-05.
The type of facility is SKILLED NURSING FACILITY. It provides long-term care. The facility administrator is GOLDBARG, RYAN.
| License Number | 010000158 |
| License Status | ACTIVE |
| License Effective Date | 2023-05-16 00:00:00 |
| License Expiration Date | 2024-05-15 00:00:00 |
| National Provider Identifier (NPI) | 1871594614 |
| CCN (CMS Certification Number) | 055987 |
| Entity Type | LIMITED LIABILITY COMPANY |
| T18 / T19 | T18 OR T18/19 |
| Facility Type | SKILLED NURSING FACILITY |
| Critical Access Hospital facility | No |
| Birthing Facility | |
| Approval Date | 2024-02-05 00:00:00 |
| Parent Facility | |
| Type of Care |
| Facility Administrtor | |
| RENEWALS@ENSIGNSERVICES.NET | |
| Street Address | 1250 BROADWAY |
| City | SONOMA |
| State | California |
| ZIP | 95476 |
| Phone | (707) 938-8406 |
| Fax | (707) 938-4400 |
The California Department of Public Health (CDPH), Center for Health Care Quality, Licensing and Certification (L&C) Program licenses and certifies more than 30 types of healthcare facilities. You can search California healthcare facilities that are operational and have a current license issued by the CDPH and/or a current U.S. Department of Health and Human Services’ Centers for Medicare and Medicaid Services (CMS) certification.
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