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Organization
FALLBROOK HEALTHCARE CENTER OPERATING COMPANY, LLC
Active
Organization
FALLBROOK HEALTHCARE CENTER OPERATING COMPANY, LLC
Active
Other names
Fallbrook Skilled Nursing
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES BARRY KILIAN (CHIEF FINANCIAL OFFICER)
(909) 796-2595
Entity
Organization
Contact information
Practice address
325 POTTER ST, FALLBROOK, CA 92028-3068
(760) 728-2330
(760) 728-5844
Mailing address
PO BOX 3000, LOMA LINDA, CA 92354-9000
(909) 796-2595
(909) 796-8797
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
550003129
STATE LICENSE NUMBER
CA
05
—
ZZT05298I
—
CA
Enumeration date
02/11/2015
Last updated
11/30/2016
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