| NPI | 1073927331 |
|---|---|
| Doing Business As | LAKE PORT SQUARE HEALTH CENTER |
| Entity Type | Organization |
| Authorized Contact | JEFFREY MILLER CEO/President 949-407-0700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2021-02-10 |