Organization
KUMQUAT HOLDINGS, LLC
Active
Other names
Primrose Post-Acute
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MITCHELL (SECRETARY)
(385) 988-3319
Entity
Organization
Contact information
Practice address
515 CENTINELA AVE, INGLEWOOD, CA 90302-3215
(310) 674-4500
Mailing address
262 N UNIVERSITY AVE, FARMINGTON, UT 84025-2975
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
910000024
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972721355
—
CA
Enumeration date
07/20/2015
Last updated
08/20/2024
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