Healthcare Provider Details

I. General information

NPI: 1750016259
Provider Name (Legal Business Name): GARDEN GROVE POST ACUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2022
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12332 GARDEN GROVE BLVD
GARDEN GROVE CA
92843-1804
US

IV. Provider business mailing address

12332 GARDEN GROVE BLVD
GARDEN GROVE CA
92843-1804
US

V. Phone/Fax

Practice location:
  • Phone: 714-534-1041
  • Fax:
Mailing address:
  • Phone: 714-534-1041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: ADRIAN DEHGHANMANESH
Title or Position: CFO
Credential:
Phone: 714-577-3880