Organization
COLLINGWOOD MANOR LLC
Active
Other names
Collingwood Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY P MILLER (CHIEF LEGAL COUNSEL)
(619) 441-8771
Entity
Organization
Contact information
Practice address
553 F STREET, CHULA VISTA, CA 91910-3515
(619) 426-8611
(619) 426-2315
Mailing address
553 F STREET, CHULA VISTA, CA 91910-3515
(619) 426-8611
(619) 426-2315
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
090000120
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT 11310G
—
CA
Enumeration date
11/28/2006
Last updated
01/13/2014
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