- Enrollment id
- O20151103000755
- Enrollment state
- CA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1720464993
- Multiple npi flag
- N
- Ccn
- 055443
- Associate id
- 2264742337
- Organization name
- WEST VALLEYIDENCE OPCO, LLC
- Doing business as name
- WEST VALLEY POST ACUTE
- Incorporation date
- 2015-06-08
- Incorporation state
- CA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- WEST VALLEY POST ACUTE
- Affiliation entity name
- PACS GROUP
- Affiliation entity id
- 690
- Address line 1
- 7057 SHOUP AVE
- City
- WEST HILLS
- State
- CA
- Zip code
- 913072335