Healthcare Provider Details

I. General information

NPI: 1053345660
Provider Name (Legal Business Name): GENERATIONS HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 09/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20371 IRVINE AVE SUITE 210
SANTA ANA CA
92707-5651
US

IV. Provider business mailing address

6 HUTTON CENTRE DR STE 400
SANTA ANA CA
92707-8762
US

V. Phone/Fax

Practice location:
  • Phone: 714-241-5600
  • Fax:
Mailing address:
  • Phone: 714-241-5600
  • 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: LOIS MASTROCOLA
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 714-241-5600