- Enrollment id
- O20141216002222
- Enrollment state
- CA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1073916987
- Multiple npi flag
- N
- Ccn
- 555871
- Associate id
- 3678896032
- Organization name
- CLAYDELLE HEALTHCARE LLC
- Doing business as name
- SOMERSET POST ACUTE CARE
- Incorporation date
- 2014-09-10
- Incorporation state
- NV
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- SOMERSET POST ACUTE CARE
- Affiliation entity name
- THE ENSIGN GROUP
- Affiliation entity id
- 507
- Address line 1
- 151 CLAYDELLE AVE
- City
- EL CAJON
- State
- CA
- Zip code
- 920204505