# 551 GIBSON AVE SNF LLC

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

## Provider details

- **NPI number:** 1477298107
- **Authorized official:** RICHARD MARTIN (MANAGER)
- **Authorized official phone:** (831) 657-5200

## Contact information

- **Practice address:** 551 GIBSON AVE, PACIFIC GROVE, CA 93950-4330
- **Practice address phone:** (831) 657-5200
- **Mailing address:** 4747 VIEWRIDGE AVE STE 105, SAN DIEGO, CA 92123-1688
- **Mailing address phone:** (619) 402-3044

## Taxonomy

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

## Other

- **Enumeration date:** 04/27/2022
- **Last updated:** 04/27/2022