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Organization

COUNTRY CREST, LLC

Active
Other names
Country Crest Post Acute
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RYAN O'HARA (CFO)
(888) 309-0022
Entity
Organization

Contact information

Practice address
50 CONCORDIA LANE, OROVILLE, CA 95966
(530) 533-7857
(530) 533-7887
Mailing address
530 N. PUENTE STREET, BREA, CA 92821
(530) 533-7857
(530) 533-7887

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
230000351
CA
314000000X
Skilled Nursing Facility

Other

Enumeration date
05/14/2012
Last updated
03/10/2014
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