Organization
JEFFREY PINE HOLDINGS, LLC
Active
Other names
Villa Las Palmas Healthcare Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN MITCHELL (SECRETARY)
(385) 988-3319
Entity
Organization
Contact information
Practice address
622 S ANZA ST, EL CAJON, CA 92020-6602
(619) 442-0544
(619) 442-6177
Mailing address
262 N UNIVERSITY AVE, FARMINGTON, UT 84025-2975
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
090000026
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023048295
—
CA
05
—
LTC70085G
—
CA
05
—
ZZT05806I
—
CA
Enumeration date
07/04/2006
Last updated
08/20/2024
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