Organization
MELON HOLDINGS LLC
Active
Other names
Marysville Post-Acute
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN MITCHELL (SECRETARY)
(385) 988-3319
Entity
Organization
Contact information
Practice address
1617 RAMIREZ ST, MARYSVILLE, CA 95901-4334
(530) 742-7311
Mailing address
262 N UNIVERSITY AVE, FARMINGTON, UT 84025-2975
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184014680
—
CA
01
—
555682
PTAN
CA
Enumeration date
02/04/2015
Last updated
08/20/2024
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