Organization
DRAGONFRUIT HOLDINGS, LLC
Active
Other names
Canyon Springs Post-Acute
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MITCHELL (SECRETARY)
(385) 518-1814
Entity
Organization
Contact information
Practice address
180 N JACKSON AVE, SAN JOSE, CA 95116-1907
(408) 259-8700
Mailing address
262 N UNIVERSITY AVE # 200, FARMINGTON, UT 84025-2975
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639548308
—
CA
Enumeration date
09/23/2015
Last updated
08/19/2024
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