- Enrollment id
- O20070924000808
- Enrollment state
- CA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1447444856
- Multiple npi flag
- N
- Ccn
- 056322
- Associate id
- 3779677554
- Organization name
- VERDUGO VALLEY SKILLED NURSING & WELLNESS CENTRE, LLC
- Doing business as name
- MONTROSE SPRINGS SKILLED NURSING & WELLNESS CENTER
- Incorporation date
- 2007-07-16
- Incorporation state
- CA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- MONTROSE SPRINGS SKILLED NURSING & WELLNESS CENTER
- Affiliation entity name
- PACIFIC HEALTHCARE HOLDINGS
- Affiliation entity id
- 792
- Address line 1
- 2635 HONOLULU AVE
- City
- MONTROSE
- State
- CA
- Zip code
- 910201706