Organization
EVERGREEN AT FULLERTON, L.L.C.
Active
Parent organization
EMPRES CALIFORNIA HEALTHCARE, LLC
Other names
Fullerton Post Acute Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
EMPRES CALIFORNIA HEALTHCARE, LLC
Authorized official
MR. DALE L. PATTERSON (MANAGER)
(360) 892-6628
Entity
Organization
Contact information
Practice address
2222 N HARBOR BLVD, FULLERTON, CA 92835-2605
(714) 992-5701
(714) 526-4884
Mailing address
2222 N HARBOR BLVD, FULLERTON, CA 92835-2605
(714) 992-5701
(714) 526-4884
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
060000205
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC55532F
—
CA
Enumeration date
05/04/2006
Last updated
01/02/2014
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