# NOTELLAGE CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** College Vista Convalescent Hospital
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679562557
- **Authorized official:** MRS. JEANNE NELSON (A/R MANAGER)
- **Authorized official phone:** (714) 577-3880

## Contact information

- **Practice address:** 4681 EAGLE ROCK BLVD, LOS ANGELES, CA 90041
- **Practice address phone:** (323) 257-8151
- **Practice address fax:** (323) 257-2187
- **Mailing address:** 3050 SATURN STREET, STE 201, BREA, CA 92821
- **Mailing address phone:** (714) 577-3880
- **Mailing address fax:** (714) 577-3895

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 970000044 | CA | Yes |

## Other

- **Enumeration date:** 10/13/2005
- **Last updated:** 10/12/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZZ0T5538H | — | CA |