- Enrollment id
- O20210604002003
- Enrollment state
- CA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1881210847
- Multiple npi flag
- N
- Ccn
- 555923
- Associate id
- 2860891231
- Organization name
- GHC OF TEM-SNF, LLC
- Doing business as name
- TEMECULA HEALTHCARE CENTER
- Incorporation date
- 2020-01-07
- Incorporation state
- CA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- TEMECULA HEALTHCARE CENTER
- Affiliation entity name
- GENERATIONS HEALTHCARE
- Affiliation entity id
- 236
- Address line 1
- 44280 CAMPANULA WAY
- City
- TEMECULA
- State
- CA
- Zip code
- 925927902