Organization
INNOVATIVE LAKE FOREST OPERATIONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICK DOBRON (VICE PRESIDENT)
(760) 690-5262
Entity
Organization
Contact information
Practice address
23442 EL TORO RD, LAKE FOREST, CA 92630-6979
(800) 584-8084
Mailing address
1282 PACIFIC OAKS PL, ESCONDIDO, CA 92029-2900
(760) 690-5262
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
PENDING
CA
Other
Enumeration date
10/30/2007
Last updated
10/30/2007
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