Organization
PACIFIC COAST CONGREGATE, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE NAZLIKIAN (OWNER)
(818) 575-0075
Entity
Organization
Contact information
Practice address
390 FULTON ST, CAMARILLO, CA 93010-6545
(818) 575-0075
Mailing address
390 FULTON ST, CAMARILLO, CA 93010-6545
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
10/08/2021
Last updated
10/08/2021
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