Organization
POPLAR HOLDINGS, LLC
Active
Other names
Poway Healthcare Center
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MITCHELL (SECRETARY)
(385) 988-3319
Entity
Organization
Contact information
Practice address
15632 POMERADO RD, POWAY, CA 92064-2406
(858) 485-5153
(858) 485-7694
Mailing address
262 N UNIVERSITY AVE, FARMINGTON, UT 84025-2975
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407035512
—
CA
05
—
LTC55136I
—
CA
Enumeration date
10/25/2007
Last updated
08/20/2024
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