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Organization
PACIFICA SL GROVE STREET LP
Active
Organization
PACIFICA SL GROVE STREET LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARLENE NELSON (DIR OF QUALITY ASSURANCE AND RISK M)
(619) 296-9000
Entity
Organization
Contact information
Practice address
725 GROVE STREET, HEALDSBURG, CA 95448
(707) 433-4877
(707) 487-5974
Mailing address
1775 HANCOCK STREET, SUITE 200, SAN DIEGO, CA 92110
(619) 296-9000
(619) 296-9090
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
—
—
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
02/12/2018
Last updated
02/05/2020
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