- Enrollment id
- O20160204000763
- Enrollment state
- CA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1083019657
- Multiple npi flag
- N
- Ccn
- 055677
- Associate id
- 3072822196
- Organization name
- PITTSBURG SKILLED NURSING GROUP INC
- Doing business as name
- PITTSBURG SKILLED NURSING CENTER
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Nursing home provider name
- PITTSBURG SKILLED NURSING CENTER
- Address line 1
- 535 SCHOOL ST
- City
- PITTSBURG
- State
- CA
- Zip code
- 945653937