Organization
ROOSEVELT LAKE HOLDINGS LLC
Active
Other names
Sierra Vista Post-Acute
Organization subpart
No
Provider details
NPI number
Authorized official
TOBY TILFORD (CEO)
(858) 774-8342
Entity
Organization
Contact information
Practice address
1900 COFFEE RD, MODESTO, CA 95355-2703
(209) 526-1775
Mailing address
16544 FRANZEN FARM RD, SAN DIEGO, CA 92127-2240
(858) 798-5700
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
08/01/2025
Last updated
08/01/2025
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