| NPI | 1184619736 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWEN ELLEN VANGELISTO Director Of Accounts Receivable 949-463-0893 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: PA 182102) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2025-06-02 |