- Enrollment id
- O20110316000221
- Enrollment state
- CA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1295831139
- Multiple npi flag
- N
- Ccn
- 055984
- Associate id
- 6406038207
- Organization name
- ANAHEIM HEALTHCARE CENTER LLC
- Doing business as name
- SUN MAR HEALTHCARE
- Incorporation date
- 1995-11-08
- Incorporation state
- CA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- ANAHEIM HEALTHCARE CENTER, LLC
- Affiliation entity name
- DAVID JOHNSON
- Affiliation entity id
- 851
- Address line 1
- 501 S BEACH BLVD
- City
- ANAHEIM
- State
- CA
- Zip code
- 928041810