Organization
DAISY HOLDINGS, LLC
Active
Other names
PINE CREEK CARE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MITCHELL (SECRETARY)
(385) 988-3319
Entity
Organization
Contact information
Practice address
1139 CIRBY WAY, ROSEVILLE, CA 95661-4421
(916) 782-7007
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
—
1437457645
—
CA
Enumeration date
03/11/2011
Last updated
08/19/2024
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