Organization
GHC OF UPLAND SNF, LLC
Active
Other names
Heritage Park Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
ROBYNE WELLBORN (AR SYSTEMS MANAGER)
(760) 315-0984
Entity
Organization
Contact information
Practice address
275 GARNET WAY, UPLAND, CA 91786-5932
(909) 949-4887
(909) 949-8761
Mailing address
275 GARNET WAY, UPLAND, CA 91786-5932
(909) 949-4887
(909) 949-8761
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
240000465
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC55514F
—
CA
Enumeration date
12/28/2007
Last updated
08/02/2024
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