Healthcare Provider Details

I. General information

NPI: 1598871808
Provider Name (Legal Business Name): SOMERSET SPECIAL CARE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 02/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 CLAYDELLE AVE
EL CAJON CA
92020-4505
US

IV. Provider business mailing address

151 CLAYDELLE AVE
EL CAJON CA
92020-4505
US

V. Phone/Fax

Practice location:
  • Phone: 619-442-0245
  • Fax: 619-442-3631
Mailing address:
  • Phone: 619-442-0245
  • Fax: 619-442-3631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number090000027
License Number StateCA

VIII. Authorized Official

Name: MS. MARY PATRICIA MILLER
Title or Position: CHIEF LEGAL COUNSEL
Credential:
Phone: 619-441-8771