- Enrollment id
- O20050715000018
- Enrollment state
- CA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1275513293
- Multiple npi flag
- N
- Ccn
- 056388
- Associate id
- 0042246563
- Organization name
- PARADISE VALLEY HEALTH CARE CENTER, INC
- Doing business as name
- PARADISE VALLEY HEALTH CARE CENTER
- Incorporation date
- 1992-03-05
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Nursing home provider name
- PARADISE VALLEY HEALTH CARE
- Affiliation entity name
- PACS GROUP
- Affiliation entity id
- 690
- Address line 1
- 2575 EAST 8TH STREET
- City
- NATIONAL CITY
- State
- CA
- Zip code
- 919502913