Healthcare Provider Details
I. General information
NPI: 1437884038
Provider Name (Legal Business Name): LA HABRA POST ACUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/19/2022
Last Update Date: 07/19/2022
Certification Date: 07/19/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1233 W LA HABRA BLVD
LA HABRA CA
90631-5226
US
IV. Provider business mailing address
1233 W LA HABRA BLVD
LA HABRA CA
90631-5226
US
V. Phone/Fax
- Phone: 562-691-0781
- Fax:
- Phone: 562-691-0781
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAVID
JOHNSON
Title or Position: CEO
Credential:
Phone: 714-577-3880