MEDICARE: GENTLE HOLDINGS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1043198559
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENTLE HOLDINGS LLC

Provider Business Mailing Address
First Line	:	PO BOX 1471
Second Line	:
City	:	BONITA
State	:	CA
Zip	:	91908-1471
Country	:	US
Telephone Number	:	619-857-3398
Fax Number	:

Provider Business Practice Location Address
First Line	:	3860 NEWTON AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92113-3227
Country	:	US
Telephone Number	:	619-857-3398
Fax Number	:

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	BRITTNEE MARES
Credential	:
Telephone Number	:	619-857-3398

Provider Enumeration Date	:	08/22/2025
Last Update Date	:	08/22/2025

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