Organization
CASA PACIFICA NURSING CENTER, LLC
Active
Other names
HARBOR VILLA CARE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB WINTNER (MANAGER)
(323) 651-1808
Entity
Organization
Contact information
Practice address
861 SOUTH HARBOR BOULEVARD, ANAHEIM, CA 92805
(714) 635-8131
(714) 635-8960
Mailing address
861 SOUTH HARBOR BOULEVARD, ANAHEIM, CA 92805
(714) 635-8131
(714) 635-8960
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
060000096
CA
314000000X
Skilled Nursing Facility
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT05742G
—
CA
Enumeration date
09/19/2005
Last updated
06/24/2014
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