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General NPI Number Information
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NPI Number | 1861845836
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Entity Type | Organization
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Legal Business Name | TRESTLES HOLDINGS LLC
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Dates
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Enumeration Date | 07/14/2016
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Last Update Date | 08/18/2023
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Provider Practice Location Address
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Address Line | 450 HAYES LN
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City | PETALUMA
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State | CA
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Zip | 94952-4010
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Country | US
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Telephone | 707-778-8686
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Fax |
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Provider Business Mailing Address
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Address Line | 701 PALOMAR AIRPORT RD STE 230
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City | CARLSBAD
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State | CA
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Zip | 92011-1046
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Country | US
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Telephone | 760-656-6985
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DANIEL GILL
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Credential |
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Telephone | 760-656-6985
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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 | CA
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