Organization
EXTENDED CARE PORTFOLIO MULTISTATE POOL TENANT, LLC
Active
Other names
Pacifica Senior Living Millcreek
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEEPAK ISRANI (MANAGER)
(619) 296-9000
Entity
Organization
Contact information
Practice address
777 E 3900 S, SALT LAKE CITY, UT 84107-2199
(801) 288-0700
(801) 288-2777
Mailing address
1775 HANCOCK ST STE 200, SAN DIEGO, CA 92110-2036
(619) 296-9000
(619) 296-9090
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
UT000249
UT
310400000X
Assisted Living Facility
Primary
UT207219
UT
Other
Enumeration date
08/15/2014
Last updated
08/15/2014
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