Organization
HAWTHORNE HOLDINGS, LLC
Active
Other names
White Blossom Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN MITCHELL (SECRETARY)
(385) 988-3319
Entity
Organization
Contact information
Practice address
1990 FRUITDALE AVE, SAN JOSE, CA 95128-2709
(408) 998-8447
(408) 288-9812
Mailing address
262 N UNIVERSITY AVE, FARMINGTON, UT 84025-2975
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
070000120
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720024391
—
CA
05
—
ZZR55068I
—
CA
Enumeration date
06/21/2006
Last updated
08/20/2024
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