Organization
SKILLED MIRAGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT KIRBY (CEO)
(619) 201-5888
Entity
Organization
Contact information
Practice address
72201 COUNTRY CLUB DR, RANCHO MIRAGE, CA 92270-4001
(760) 340-5999
Mailing address
72201 COUNTRY CLUB DR, RANCHO MIRAGE, CA 92270-4001
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
12/02/2020
Last updated
12/02/2020
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