Organization
BLYTHE POST ACUTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID JOHNSON (CEO)
(888) 309-0022
Entity
Organization
Contact information
Practice address
285 W CHANSLOR WAY, BLYTHE, CA 92225-1246
(760) 922-8176
Mailing address
530 N PUENTE ST, BREA, CA 92821-2804
(888) 309-0022
(714) 256-2003
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC90055I
—
CA
Enumeration date
11/04/2014
Last updated
12/30/2016
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