Organization
LANTERN OF CRESCENT CITY, LLC
Active
Parent organization
SRSO, LLC
Other names
Lantern Health Crescent City
Organization subpart
Yes
Provider details
NPI number
Legal business name
SRSO, LLC
Authorized official
SPENCER ROBERT SAMUELIAN (MANAGER)
(949) 445-1000
Entity
Organization
Contact information
Practice address
4 S STONINGTON RD, LAGUNA BEACH, CA 92651-6741
(949) 445-1000
Mailing address
4 S STONINGTON RD, LAGUNA BEACH, CA 92651-6741
(949) 445-1000
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
CA
Other
Enumeration date
12/09/2014
Last updated
12/09/2014
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