- Enrollment id
- O20140324001402
- Enrollment state
- CA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1285061085
- Multiple npi flag
- N
- Ccn
- 555659
- Associate id
- 6709017361
- Organization name
- PEPPERBUSH HOLDINGS LLC
- Doing business as name
- SAN DIEGO POST-ACUTE CENTER
- Incorporation date
- 2013-09-04
- Incorporation state
- DE
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- SAN DIEGO POST-ACUTE CENTER
- Affiliation entity name
- PACS GROUP
- Affiliation entity id
- 690
- Address line 1
- 1201 S ORANGE AVE
- City
- EL CAJON
- State
- CA
- Zip code
- 920207521