# PACIFICA SL GROVE STREET LP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184124513
- **Authorized official:** MARLENE NELSON (DIR OF QUALITY ASSURANCE AND RISK M)
- **Authorized official phone:** (619) 296-9000

## Contact information

- **Practice address:** 725 GROVE STREET, HEALDSBURG, CA 95448
- **Practice address phone:** (707) 433-4877
- **Practice address fax:** (707) 487-5974
- **Mailing address:** 1775 HANCOCK STREET, SUITE 200, SAN DIEGO, CA 92110
- **Mailing address phone:** (619) 296-9000
- **Mailing address fax:** (619) 296-9090

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311500000X | Alzheimer Center (Dementia Center) | — | — | — |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 02/12/2018
- **Last updated:** 02/05/2020