Organization
SANTA ROSA POSTACUTE CARE LLC
Active
Other names
Northvine Postacute Care
Organization subpart
No
Provider details
NPI number
Authorized official
MANEESH A. BANSAL (CHIEF EXECUTIVE OFFICER)
(424) 349-7108
Entity
Organization
Contact information
Practice address
446 ARROWOOD DR, SANTA ROSA, CA 95407-7503
(707) 528-2100
(562) 457-5584
Mailing address
721 N EUCLID ST STE 200, ANAHEIM, CA 92801-4116
(424) 349-7108
(562) 457-5584
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
056259
—
CA
Enumeration date
07/11/2017
Last updated
11/19/2024
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