Organization
LOS GATOS SNF, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANEESH BANSAL (CEO)
(562) 924-9618
Entity
Organization
Contact information
Practice address
16605 LARK AVE., LOS GATOS, CA 95032
(562) 924-9618
Mailing address
16605 LARK AVE, LOS GATOS, CA 95032-7642
(562) 924-9618
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
070000067
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070000067
FACILITY LICENSE NUMBER
CA
Enumeration date
05/26/2015
Last updated
08/13/2015
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