Healthcare Provider Details
I. General information
NPI: 1619339306
Provider Name (Legal Business Name): VENTURA POST ACUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/22/2016
Last Update Date: 05/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4020 LOMA VISTA RD
VENTURA CA
93003-1801
US
IV. Provider business mailing address
4115 E BROADWAY
LONG BEACH CA
90803-1532
US
V. Phone/Fax
- Phone: 805-642-4196
- Fax:
- Phone: 562-930-0777
- Fax: 562-930-0728
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | CA |
VIII. Authorized Official
Name:
JANET
MANDELBAUM
Title or Position: MANAGER
Credential:
Phone: 562-930-0777