# PACIFIC VILLA, INC.

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

## Provider details

- **NPI number:** 1447656566
- **Authorized official:** MS. VICKI P ROLLINS RN (VICE-PRESIDENT)
- **Authorized official phone:** (626) 331-0781

## Contact information

- **Practice address:** 3501 CEDAR AVE, LONG BEACH, CA 90807-3809
- **Practice address phone:** (626) 331-0781
- **Practice address fax:** (626) 966-7353
- **Mailing address:** PO BOX 5004, GLENDORA, CA 91740-0019
- **Mailing address phone:** (626) 331-0781
- **Mailing address fax:** (626) 966-7353

## Taxonomy

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

## Other

- **Enumeration date:** 11/17/2014
- **Last updated:** 02/11/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 05-6313 | PTAN | CA |
| 01 | — | 1447656566 | NPI NUMBER | CA |
| 05 | — | 940000130 | — | CA |