Organization
WATERMANIDENCE OPCO, LLC
Active
Other names
Waterman Canyon Post Acute
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MITCHELL (SECRETARY)
(385) 988-3319
Entity
Organization
Contact information
Practice address
1850 N WATERMAN AVE, SAN BERNARDINO, CA 92404-4831
(909) 882-1215
(909) 881-2071
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
12/18/2014
Last updated
08/20/2024
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