Organization
SANTA ROSAIDENCE OPCO, LLC
Active
Other names
Santa Rosa Post Acute
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MITCHELL (SECRETARY)
(385) 988-3319
Entity
Organization
Contact information
Practice address
4650 HOEN AVE, SANTA ROSA, CA 95405-9407
(707) 546-0471
Mailing address
262 N UNIVERSITY AVE, FARMINGTON, UT 84025-2975
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
11/15/2016
Last updated
08/20/2024
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