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Organization
BALBOA HEALTHCARE, INC.
Active
Organization
BALBOA HEALTHCARE, INC.
Active
Other names
Balboa Nursing and Rehabilitation Center, Balboa Nursing & Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MITCHELL (SECRETARY)
(385) 988-3319
Entity
Organization
Contact information
Practice address
3520 4TH AVE, SAN DIEGO, CA 92103-4913
(619) 291-5270
(619) 291-1671
Mailing address
262 N UNIVERSITY AVE, FARMINGTON, UT 84025-2975
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
090000057
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
090000057
CDPH FACILITY LICENSE NUMBER
CA
05
—
LTC06105I
—
CA
Enumeration date
05/02/2006
Last updated
08/19/2024
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