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Organization
GRAND TERRACE HEALTH CARE, INC.
Active
Organization
GRAND TERRACE HEALTH CARE, INC.
Active
Other names
GRAND TERRACE CARE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MARC JOHNSON (CFO)
(949) 373-8373
Entity
Organization
Contact information
Practice address
12000 MOUNT VERNON AVE, GRAND TERRACE, CA 92313-5174
(909) 825-5221
Mailing address
25910 ACERO STE 350, MISSION VIEJO, CA 92691-7908
(949) 441-9258
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
240000143
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT05129J
—
CA
Enumeration date
12/09/2005
Last updated
04/05/2024
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