# LCS SANTA ROSA LLC

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

## Provider details

- **NPI number:** 1184246639
- **Authorized official:** JOEL NELSON (MANAGER, PRESIDENT & CEO)
- **Authorized official phone:** (515) 875-4500

## Contact information

- **Practice address:** 300 FOUNTAINGROVE PKWY, SANTA ROSA, CA 95403-5720
- **Practice address phone:** (707) 566-8600
- **Practice address fax:** (844) 319-0816
- **Mailing address:** 400 LOCUST ST STE 820, DES MOINES, IA 50309-2334
- **Mailing address phone:** (515) 875-4500
- **Mailing address fax:** (844) 319-0816

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 05/07/2020
- **Last updated:** 05/07/2020