# CASA PACIFICA NURSING CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** HARBOR VILLA CARE CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902891641
- **Authorized official:** JACOB WINTNER (MANAGER)
- **Authorized official phone:** (323) 651-1808

## Contact information

- **Practice address:** 861 SOUTH HARBOR BOULEVARD, ANAHEIM, CA 92805
- **Practice address phone:** (714) 635-8131
- **Practice address fax:** (714) 635-8960
- **Mailing address:** 861 SOUTH HARBOR BOULEVARD, ANAHEIM, CA 92805
- **Mailing address phone:** (714) 635-8131
- **Mailing address fax:** (714) 635-8960

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 060000096 | CA | Yes |
| 314000000X | Skilled Nursing Facility | — | CA | — |

## Other

- **Enumeration date:** 09/19/2005
- **Last updated:** 06/24/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZZT05742G | — | CA |