Organization
GAHC4 WEST HAVEN UT TRS SUB, LLC
Active
Other names
Lotus Park Care Centers
Organization subpart
No
Provider details
NPI number
Authorized official
DANNY PROSKY (PRESIDENT)
(949) 270-9200
Entity
Organization
Contact information
Practice address
2639 W 3520 S, WEST HAVEN, UT 84401-8529
(801) 732-5290
Mailing address
18191 VON KARMAN AVE STE 300, IRVINE, CA 92612-7106
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
12/06/2019
Last updated
12/10/2019
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