Healthcare Provider Details
I. General information
NPI: 1508327446
Provider Name (Legal Business Name): THOUSAND OAKS POST ACUTE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/25/2019
Last Update Date: 04/28/2022
Certification Date: 04/28/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
93 W AVENIDA DE LOS ARBOLES
THOUSAND OAKS CA
91360-2939
US
IV. Provider business mailing address
400 EXCHANGE STE 140
IRVINE CA
92602-1343
US
V. Phone/Fax
- Phone: 805-492-2444
- Fax:
- Phone:
- 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:
JOSE
LYNCH
Title or Position: MANAGING MEMBER
Credential:
Phone: 714-673-6810