Organization
SUN VILLAIDENCE OPCO, LLC
Active
Other names
Sequoia Transitional Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN MITCHELL (SECRETARY)
(385) 988-3319
Entity
Organization
Contact information
Practice address
350 N VILLA ST, PORTERVILLE, CA 93257-3211
(559) 784-6644
(559) 784-3178
Mailing address
262 N UNIVERSITY AVE, FARMINGTON, UT 84025-2975
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
120000589
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT05551I
—
CA
Enumeration date
05/17/2007
Last updated
08/20/2024
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