# GHC OF SAN JOSE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Vista Manor Nursing Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104820562
- **Authorized official:** LOIS MASTROCOLA (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (714) 241-5600

## Contact information

- **Practice address:** 120 JOSE FIGUERES AVE, SAN JOSE, CA 95116-1528
- **Practice address phone:** (408) 272-1400
- **Practice address fax:** (408) 272-4695
- **Mailing address:** 120 JOSE FIGUERES AVE, SAN JOSE, CA 95116-1528
- **Mailing address phone:** (408) 272-1400
- **Mailing address fax:** (408) 272-4695

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 070000210 | CA | Yes |

## Other

- **Enumeration date:** 06/13/2005
- **Last updated:** 08/05/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | LTC55483G | — | CA |