Healthcare Provider Details

I. General information

NPI: 1275962482
Provider Name (Legal Business Name): OJAI HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2013
Last Update Date: 09/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N MONTGOMERY ST
OJAI CA
93023-2751
US

IV. Provider business mailing address

601 N MONTGOMERY ST
OJAI CA
93023-2751
US

V. Phone/Fax

Practice location:
  • Phone: 310-390-9045
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number500020
License Number StateCA

VIII. Authorized Official

Name: AARON MOAS
Title or Position: ADMINISTRATOR
Credential:
Phone: 18066468124