- Enrollment id
- O20150220001777
- Enrollment state
- CA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1396143962
- Multiple npi flag
- N
- Ccn
- 555856
- Associate id
- 2769707405
- Organization name
- PEAR HOLDINGS LLC
- Doing business as name
- PENINSULA POST-ACUTE
- Incorporation date
- 2014-10-10
- Incorporation state
- DE
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- PENINSULA POST-ACUTE
- Affiliation entity name
- PACS GROUP
- Affiliation entity id
- 690
- Address line 1
- 1609 TROUSDALE DR
- City
- BURLINGAME
- State
- CA
- Zip code
- 940104520