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Organization
PACIFIC VILLA, INC.
Active
Organization
PACIFIC VILLA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VICKI P ROLLINS RN (VICE-PRESIDENT)
(626) 331-0781
Entity
Organization
Contact information
Practice address
3501 CEDAR AVE, LONG BEACH, CA 90807-3809
(626) 331-0781
(626) 966-7353
Mailing address
PO BOX 5004, GLENDORA, CA 91740-0019
(626) 331-0781
(626) 966-7353
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05-6313
PTAN
CA
01
—
1447656566
NPI NUMBER
CA
05
—
940000130
—
CA
Enumeration date
11/17/2014
Last updated
02/11/2016
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