Organization
LAKE BALBOA HEALTH CARE, INC.
Active
Other names
LAKE BALBOA POST-ACUTE REHAB
Organization subpart
No
Provider details
NPI number
Authorized official
MARC JOHNSON (CFO)
(949) 373-8373
Entity
Organization
Contact information
Practice address
16955 VANOWEN ST, VAN NUYS, CA 91406-4542
(818) 343-0700
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
920000005
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT06180I
—
CA
Enumeration date
12/08/2005
Last updated
04/05/2024
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