# INNOVATIVE LAKE FOREST OPERATIONS, LLC

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

## Provider details

- **NPI number:** 1437338217
- **Authorized official:** NICK DOBRON (VICE PRESIDENT)
- **Authorized official phone:** (760) 690-5262

## Contact information

- **Practice address:** 23442 EL TORO RD, LAKE FOREST, CA 92630-6979
- **Practice address phone:** (800) 584-8084
- **Mailing address:** 1282 PACIFIC OAKS PL, ESCONDIDO, CA 92029-2900
- **Mailing address phone:** (760) 690-5262

## Taxonomy

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

## Other

- **Enumeration date:** 10/30/2007
- **Last updated:** 10/30/2007