Organization
GORDON LANE HEALTHCARE LLC
Active
Other names
Gordon Lane Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JEANNE M NELSON (AR MANAGER)
(714) 577-3880
Entity
Organization
Contact information
Practice address
1821 E CHAPMAN AVE, FULLERTON, CA 92831-4102
(714) 879-7301
(714) 224-3320
Mailing address
3050 SATURN ST, STE 201, BREA, CA 92821-6221
(714) 577-3880
(714) 577-3892
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
060000118
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC55797F
—
CA
Enumeration date
09/16/2006
Last updated
06/03/2015
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