- Enrollment id
- O20160219000501
- Enrollment state
- CA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1356716815
- Multiple npi flag
- N
- Ccn
- 555732
- Associate id
- 9739484353
- Organization name
- SANTA FE HEIGHTS HEALTHCARE CENTER LLC
- Incorporation date
- 2015-11-25
- Incorporation state
- CA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- SANTA FE HEIGHTS HEALTHCARE CENTER, LLC
- Affiliation entity name
- CRYSTAL SOLORZANO
- Affiliation entity id
- 752
- Address line 1
- 2309 N SANTA FE AVE
- City
- COMPTON
- State
- CA
- Zip code
- 902222824