Organization
200 LIGHTHOUSE, LLC
Active
Other names
Pacific Grove Healthcare Center
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD MARTIN (MANAGER)
(619) 402-3044
Entity
Organization
Contact information
Practice address
200 LIGHTHOUSE AVE, PACIFIC GROVE, CA 93950-3022
(931) 375-2695
Mailing address
200 LIGHTHOUSE AVE, PACIFIC GROVE, CA 93950-3022
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
03/06/2019
Last updated
03/06/2019
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