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General NPI Number Information
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NPI Number | 1134045750
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Entity Type | Organization
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Legal Business Name | TOMOKA RIVER HOLDINGS LLC
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Dates
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Enumeration Date | 06/26/2026
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Last Update Date | 06/26/2026
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Provider Practice Location Address
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Address Line | 4445 PINE FOREST DR
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City | GREENACRES
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State | FL
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Zip | 33463-4676
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Country | US
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Telephone | 858-798-5700
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Fax |
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Provider Business Mailing Address
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Address Line | 16544 FRANZEN FARM RD
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City | SAN DIEGO
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State | CA
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Zip | 92127-2240
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Country | US
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Telephone | 858-798-5700
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MR. JEFFREY DANA
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Credential |
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Telephone | 856-430-3198
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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