Organization
CANTALOUPE HOLDINGS, LLC
Active
Other names
Beachwood Post-Acute & Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MITCHELL (SECRETARY)
(385) 988-3319
Entity
Organization
Contact information
Practice address
1340 15TH ST, SANTA MONICA, CA 90404-1802
(310) 451-9700
Mailing address
262 N UNIVERSITY AVE STE 200, FARMINGTON, UT 84025-2975
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
910000016
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801836622
—
CA
Enumeration date
07/20/2015
Last updated
08/19/2024
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