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Organization
SANTA ROSAIDENCE OPCO, LLC
Active
Organization
SANTA ROSAIDENCE OPCO, LLC
Active
Other names
Santa Rosa Post Acute
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MITCHELL (SECRETARY)
(385) 988-3319
Entity
Organization
Contact information
Practice address
4650 HOEN AVE, SANTA ROSA, CA 95405-9407
(707) 546-0471
Mailing address
262 N UNIVERSITY AVE, FARMINGTON, UT 84025-2975
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
11/15/2016
Last updated
08/20/2024
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