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Organization
SANTA ROSA POSTACUTE CARE LLC
Active
Organization
SANTA ROSA POSTACUTE CARE LLC
Active
Other names
Northvine Postacute Care
Organization subpart
No
Provider details
NPI number
Authorized official
MANEESH A. BANSAL (CHIEF EXECUTIVE OFFICER)
(424) 349-7108
Entity
Organization
Contact information
Practice address
446 ARROWOOD DR, SANTA ROSA, CA 95407-7503
(707) 528-2100
(562) 457-5584
Mailing address
721 N EUCLID ST STE 200, ANAHEIM, CA 92801-4116
(424) 349-7108
(562) 457-5584
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
056259
—
CA
Enumeration date
07/11/2017
Last updated
11/19/2024
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